A Woman's Most Intimate Health Questions, Answered

"Is it normal to feel this way during sex?"

"Should I be concerned that I am bleeding right now?"

"Am I supposed to feel like this?"

"Am I normal?"

Questions like these have popped into the minds of most women at one time or another, but many are reluctant, or even ashamed, to discuss them in detail with their physicians. However, for doctors, no question is stupid and no woman should feel embarrassed to ask the most intimate of questions when it comes to her health and well-being.

"Most embarrassment comes from the perceived notion of what the physician's response will be, and how that physician has previously built trust with intimate issues," said Dr. Diane Harper, director of the Gynecologic Cancer Prevention Research Group at University of Missouri-Kansas.

And Dr. Margery Gass, executive director of the North American Menopause Society and a gynecological consultant at Cleveland Clinic, agreed, and said that any symptom or annoying condition that a woman experiences should be raised with their doctors.

"Doctors feel comfortable talking about these issues, and, what I'd really like, is for women to feel comfortable talking about them as well," said Gass.

Dr. June LaValleur, associate professor of obstetrics and gynecology at University of Minnesota, said it's the job of the doctor and the patient to create an open and inviting conversation.

"Women need to feel that their provider will be responsive to their question, so we teach residents to be 'askable' physicians," said LaValleur. "Being a gynecologist is such a special role, and it is indeed a privilege to have women as patients tell us things that are so hard for some to talk about."

Women's health experts say sensitive health concerns can range from natural body quirks to potentially life-threatening conditions. The next few pages feature a closer look at some disorders that, doctors say, women should never be ashamed to discuss.

Sex

While sex brings great pleasure and connection to many relationships, it can also be a source of stress when intimacy problems are not discussed. And that doesn't change outside of the bedroom: doctors say sex is one of the main topics that women have trouble discussing with their doctors.

First, let's talk orgasm.

"Women who have not had orgasms will very seldom say, 'I've never had an orgasm,'" said LaValleur. "They'll often skirt around the idea, so we are conscious to ask specific questions relating to orgasms and intimacy."

To note how closed-off some women can be when discussing their sex life, LaValleur recalled a patient in her 40s who came in for an annual appointment with her husband of two years. The woman had never had an orgasm. When the patient left the room to get dressed after the appointment, her husband pulled LaValleur aside to ask where the clitoris was on the body.

"Most women need to have the clitoris stimulated to orgasm and their partners sometimes don't know where it is," said LaValleur. "It's amazing what women don't know about their own body and body functions, and sometimes they're too afraid to tell their partner that what they're doing is not working for them."

"I always let a woman know that her orgasms are her own responsibility and she needs to tell her partner what she wants and needs," continued LaValleur.

Communication is often the answer to many of the sex questions that women pose, and can also be at the root of a secondary problem: a low sex drive.

Doctors say that a low libido is often a reflection of problems in the relationship, especially in pre-menopausal women. While a woman's sex drive will naturally hit highs and lows throughout her life, psychological problems, like a poor body image, history of physical or sexual abuse, and anxiety and low self-esteem can all contribute to a lack of desire. Certain medications, like anti-anxiety and anti-depressant pills, can also add to a low sex drive.

Moreover, relationship problems, like unresolved conflict, lack of trust, and poor communication of sexual preferences, can all lead to a decreased desire for sex.

Surveys reveal that about 40 million Americans live in a no-sex or low-sex marriage, defined as having intercourse ten times a year of less. Whether or not this sex life is sufficient depends on the couple. But, like most things sex-related, communication is significant, with a woman's partner and with her doctor.

Pain during Sex

Of course, if a woman experiences pain during sex, it will certainly lead to a lack of sexual desire. Doctors say that it is not normal to experience pain during intercourse, but there are many treatments available, so a woman should talk to her doctor about any sort of discomfort during intercourse.

"Pain during sex ... should be thoroughly evaluated to rule out physical causes, such as infection, scarring, [or] vulvodynia," said Dr. John Repke, chairman of the department of obstetrics and gynecology at Penn State College of Medicine.

Vulvodynia is defined as chronic pain in and around the opening of the vagina. Symptoms include burning, soreness, itching and throbbing in the genital area.

Doctors suggest that women who suffer from pain during sex use lubricants and get adequate foreplay into the mix before having sex. While not in the bedroom, women should avoid tight pants and underwear, stay active and use cold compresses to ease the pain.

If lifestyle and home remedies still don't ease the pain, there are several medications and treatments that a woman can discuss with her doctor.

Pain and dryness is particularly common in older women, said LaValleur. There are three layers of cells on the vagina, but, as women age, the layers decrease, getting down to two, then one. The opening of the vagina also gets smaller with age and women can lose their ability to lubricate. Intercourse can be very painful, and women can even bleed when trying to have intercourse without foreplay.

"There may also be a psycho-physiologic reason for painful intercourse that sometimes requires the intervention of a skilled sexual medicine specialist," Repke said.

Domestic Abuse

About one in four women will experience some sort of domestic abuse in their lifetime. While most cases of domestic violence are never reported to the police, many physicians have started to screen for emotional and physical violence during annual gynecological appointments.

Domestic abuse is broadly defined as a pattern of behavior where one partner tries to dominate and control the other person by using fear, guilt, shame and physical or emotional intimidation to wear the other person down. Both physical and emotional abuse threaten the livelihood and well-being of the person involved.

"These are issues that many primary care physicians cringe to hear a patient say," said Harper. "And the patient can feel that the physician is uncomfortable with the topic. [So], unless the woman is near dying from the abuse, she may choose not to say anything to the physician."

While women are much more resistant to discussing domestic abuse than almost any other subject, many doctors say that, once the trust is built, some women will begin to open up about their home life.

"We ask questions that give them the idea to talk about it," said Dr. Paula Hillard, professor in the department of obstetrics and gynecology at Stanford University School of Medicine. "For some, it takes several visits with me for them to feel comfortable enough to acknowledge [the problem]. They're ashamed."

LaValleur agreed that many women see abuse as a badge of shame, but those same women might be surprised by the prevalence of women who are affected by domestic violence.

"People have a mistaken idea that domestic abuse happens in people who are poor or in alcoholic homes, but it can happen in any socioeconomic strata," said Hillard.

Domestic violence comes in many forms, including physical aggression, sexual abuse, intimidation, stalking and neglect. Abuse does not have to be physical.

"Calling someone a bitch is abusive," said LaValleur.

When doctors find out that a patient is in an abusive household, the next question is almost always whether the woman has an escape plan for herself, and, if applicable, her children.

"A woman needs to know where she can go that is safe and who she can depend on," said LaValleur.

If you or someone you know suffers from domestic abuse, call the National Domestic Violence Hotline at 1-800-799-SAFE (7233) to gather information on a safe way out. The hotline is anonymous, confidential, and lines are open 24 hours a day, 7 days a week.

Urinary incontinence is another touchy subject for women. It is defined as an involuntary leakage of urine. It is a common problem in women of all ages, but leakage is most prevalent among older women. Approximately 13 million men and women experience incontinence in the United States. As women get older, their muscles relax in the body, causing a higher likelihood of leakage. Pregnancy, weight gain and various conditions like diabetes and stroke can also increase the risk of incontinence. Up to 50 percent of post-menopausal women may experience the condition.

"Incontinence usually is not caused by a serious problem," said Gass. "It's more of a quality-of-life issue and a nuisance," said Gass.

Treatment for incontinence varies, from bladder training and scheduled toilet trips, to Kegel exercises, medications, interventional therapies and surgery.

"Incontinence can be a reason that women end up in assisted care, or make choices to not exercise or have chronic infections related to anatomic abnormalities," said Dr. Joanna Cain, chair of obstetrics and gynecology at Warren Alpert Medical School at Brown University. "The important thing is that nowadays the majority of incontinence is treatable, including for women with other medical conditions."

Problem Bleeding

Many women experience some sort of problem bleeding at one point or another in their lives. Vaginal bleeding is considered abnormal if it occurs when a woman is not expecting her period, the period is much lighter or heavier than normal, she is bleeding while pregnant or after menopause.

Normal menstruation occurs every 21 to 35 days, when the uterus sheds its lining. While abnormal bleeding can be harmless due to ovulation or hormone changes, it can also be a sign of a variety of conditions, including endometrial cancer, miscarriage, sexually transmitted disease, hormonal changes and uterine fibroids.

Especially in older women, Repke said, "Post-menopausal bleeding should never be ignored, and should never be considered normal. While the leading cause of post-menopausal bleeding is atrophic vaginitis, this is a diagnosis of exclusion and the diagnosis that must be ruled out is cancer, specifically cancer of the endometrium."

Am I Normal?

Some of the questions that cause women the most concern and thought have nothing to do with serious medical issues, but rather, the physical appearance of their breasts and vagina.

Breasts, nipples, labia and pubic hair come in all read this blog sorts of shapes and sizes, and by and large, a woman is more likely normal than not.

While doctors said that the 'am I normal' questions are not as prevalent in older women, many teens and women in their 20s often wonder what they are supposed to look like.

"Few women put a mirror down there and look at their vulva, and they want to know if they're normal in regards to looks," said LaValleur. "They often just need reassurance that they're normal."

Along with appearance of the vagina, another worry for some women is smell. Doctors say a slight musky scent is totally normal. A fishy smell can indicate a yeast infection, which can be easily treated with prescribed medication. In some cases, a bad odor can also indicate a sexually transmitted disease. A woman should see her doctor if an odor persists. In the meantime, she should clean the external pubic area with a mild soap and avoid douching, as it can make the potential infection worse.

Whatever the condition or question, doctors encourage all their patients to feel comfortable sharing any concern they have when it comes to their well-being or their body. And, because of this, women should find a doctor with whom they feel comfortable discussing personal matters.



"I wish there was a social network for trying out doctors," said Harper. "Because we discuss personal and detailed parts of our intimate life with a doctor, it would be nice if there was some way to preview what a doctor's personality was like."

https://abcnews.go.com/Health/WomensHealth/womans-intimate-health-questions-answered/story?id=12770926

Exercise & Meditation :: Zumba dvd

All About the Zumba Workout

Imagine spending your workout minutes doing the Cha Cha, Meringue, Mambo, Salsa, and the Calypso. Throw in a little rock and roll and belly dancing and you have the core workout for the Zumba DVD series. The key to the popularity of Zumba is the dance moves . You feel as though you are dancing around, free as a bird even though the program is approved by the Aerobic and Fitness Association of America, American Council on Exercise and the Canadian Personal Trainer Association as an exercise routine. With more than 3 million people choosing to follow the Zumba dancing moves all the way to a smaller size, this 2008 fitness boom is sure to last more than 15 minutes.

The History of the Zumba Training Style

Alberto Perez is to blame for this huge phenomenon. As a fitness trainer, Perez walked into class one day without the music planned for the day's workout. In order to keep the class moving, he ran to his car and pulled out some Latin music of the more personal kind. The rest is history. The Latin beats combined with real Latin style moves and moves from some of the most popular dances have made the Zumba instructors all over the world (35 countries to be exact) a little smoother on the step.

After that first day of Zumba class with his new Zumba music, Perez knew he needed to expand his routines and make the most of this popular accident. He gathered all he knew about Zumba and headed to the United States. The year was 1999 and that is when the Zumba exercise was formally born.

The Most Fun You Can Have in Exercise

Zumba training is all about having fun and burning calories in the process. During the beginning stages of the workout, the Zumba dance steps are taught slowly in order for the newbies in the class to catch on to what is happening. As the class progresses, more and more check this out steps are added making the entire Zumba fitness routine a building process.



The cornerstone of the Zumba class is the music. No matter if you learn the steps or not, once the class is warmed up and those Latin beats hit the air you are moving to the Zumba music and burning more calories and fat than ever before while maintaining a huge level of fun. The moves are sexy, the moves are raw, and the moves can even be made up as you go along.

Who Can Do the Zumba Routines?



Probably the best part about Zumba fitness is the adaptability of the routines. The moves are set for the in class participation, but that does not mean the instructor will come and slap you on the wrist for feeling the music and moving to your own beat. Zumba is a party, it is about having fun and that sets a self guided pace. Young, old and even those with very little mobility will be able to take advantage of the great vibes created by Zumba music. One of the hardest things to do when it comes to finding the workout that you can stick to is enjoying the time spent working out. Experts believe the workouts we do need to be as much mental as they are physical. So, those days when you are running on the treadmill thinking about how little you want to be running on the treadmill are really not helping that waistline one bit.

Zumba, however, offers Zumba DVDs for young and old. The milder or less strenuous version of the Zumba exercises are aimed at the more elderly or overweight and guide you through the Zumba series with just as much upbeat fun as the more moderate workouts. The lighter version of Zumba fitness is called Zumba Gold. Zumba Gold is available in both class and DVD form.

Zumba covers every aspect of exercise one could imagine and they throw in Latin beats, Latin dance and rock and roll to round out the fun. When it comes to burning calories, the Zumba class and Zumba music make the time fly. You will never know you are working out when you choose Zumba fitness for your weight loss, fat loss and muscle toning needs. Zumba, the party everyone is attending and leaving lighter than they came.



http://www.articlebiz.com/article/576538-1-zumba-dvd/

Car expenses: Determining your budget

A new (or used) car calls for a new state registration, with fees typically running from $50 to $125. These items usually figure into the total amount you borrow with a loan or finance with a lease -- and therefore help determine your real-life monthly payments.

A good rule of thumb is to plan on spending 10% to 15% of your total monthly budget on all automotive expenses. If you are buying a new car, your warranty will cover major repairs for at least the first three years in most cases, but will usually not cover routine maintenance such as oil changes or replacement for items such as batteries, windshield wipers or tires.



A new car means higher insurance costs. (Opting for a late-model used car can cut those costs.) Your premiums for liability coverage, required of all drivers, may not change much from your old car. What will increase is the so-called collision and comprehensive portions of your policy.

Collision pays to repair accident damage to your car, while comprehensive covers theft, fire and natural disasters. Since you will want these types of coverage for a new car, your costs could shoot up sharply.

Check the record. One way you can cut your insurance costs before you buy is to choose a model that has a good safety record and/or a low theft rate. Insurance costs vary not only by model but also by metropolitan areas, and even from city to suburbs within those areas. So when you have narrowed the number of cars or trucks on your wish list to a handful, call your agent for a rate quote, or check theft and safety records on the Web.

For federal crash test results, go to www.safercar.gov. The site operated by the insurance company-sponsored Highway Loss Data Institute will give you rankings for injury and property losses for any vehicle, plus a list of the most- and least-stolen models. Both those factors affect insurance costs as well as your safety and peace of mind.

CNNMoney (New York) First published May 28, 2015: 5:31 PM Auto Body repair ET

https://money.cnn.com/pf/money-essentials-car-budget/index.html

Legal. - Free Online Library





John Seurynck and Michael Seneca to the staff of Howard &

Howard Attorneys PC in Bloomfield Hills.



[ILLUSTRATION OMITTED]





James Heimbuch, a partner in Bodman, Longley & Dahling

LLP's Detroit office, to president-elect of the Detroit

Metropolitan Bar Association.



Butzel Long attorney Reginald Pacis to a one-year term as

chairperson of the Michigan Chapter of the American Immigration Lawyers

Association.



[ILLUSTRATION OMITTED]



Thomas Linn, CEO of Miller, Canfield, Paddock and Stone PLC in

Detroit, to secretary of the Western New York 2003 Metropolitan Affairs Coalition's

executive committee.



[ILLUSTRATION OMITTED]



Deanna Butler to an associate in the Corporate Finance Practice

Group in the Detroit office of Dykema Gossett PLLC.



[ILLUSTRATION OMITTED]





COPYRIGHT 2003 Detroit Regional Chamber



No portion of this article can be reproduced without the express written permission from the copyright holder.



Copyright 2003, Gale Group. All rights reserved. Gale Group is a Thomson Corporation Company.

https://www.thefreelibrary.com/Legal.-a0111069434

Law-breaking lawyers. - Free Online Library

Byline: Prof Fajune Pirzada - Lahore

MANY cars on the roads these days seem to carry number plates that

do not subscribe to the pattern specified by the excise and taxation

department.

Since the digital registration plates were introduced, no car is

supposed to carry number plates written in the previous pattern.

Unfortunately, many car owners violating the rule are lawyers, who

now take pride in calling themselves 'attorney at law' and, in

fact, consider themselves above the law.

Even civil judges and session judges have put up name plates on

their homes proclaiming themselves as 'justice'.

The title of 'justice' is given to one elevated either to

a high court or the Supreme Court, but not anymore. Now every judge, no

matter how junior in rank and service, insists on being addressed as

'justice' and every lawyer in black coat 'attorney at

law'.

Law abiding citizens on the roads are fearful of overtaking or

crossing the path of a car that displays an illegal number plate with

'attorney at law' printed on it click here boldly. Even the traffic



police on seeing such number plates look the other way to avoid



trouble.

COPYRIGHT 2019 Knowledge Bylanes



No portion of this article can be reproduced without the express written permission from the copyright holder.

Copyright 2019 Gale, Cengage Learning. All rights reserved.

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We May Have Found Fossils From the Dinosaurs’ Last Moments on Earth

We May Have Found Fossils From the Dinosaurs' Last Moments on Earth - ExtremeTech

asteroid



Paleontologists may have found fossil beds that preserve the last moments of the dinosaur's existence as the dominant species on Earth in a breakthrough that could transform paleontology -- if it proves true.

Paleontologist Robert DePalma has been researching a site he's nicknamed Tanis for a number of years. It's part of the fossil-rich Hell Creek Formation in Montana, though the exact location has been kept secret. What makes this particular site unique is the nature of the fossils within it and the speed with which they may have been laid down.

Any time we talk about geologic time scales, there's an understood margin of error baked in. The fossil record only records a minuscule fraction of all the living things that walked the Earth. You never find a fossil that's identifiable as the first or last of a species, because you can't ever make a claim about a moment that precise in time. But if DePalma and his fellow authors are right, we do know when this particular fossil bed was laid down: within two hours of the meteorite strike at Chicxulub.

What They Found

The Tanis fossil bed is unique for two reasons. First, it appears to have been laid down learn more now extremely quickly. Objects within the field are oriented vertically, heavily mixed together, and oriented in a manner that suggests a single, massive deposit event with a mixed load of animal and plant material. Tanis was nowhere near the actual Chicxulub impact crater 66 million years ago, but the entire area is scattered with tektites -- shocked glassy objects formed as molten debris from a meteorite impact shot through the air. By calculating the speed with which debris from Chicxulub would have moved, the scientists were able to calculate how quickly the tektites would have arrived.

The researchers analyzed the various types of meteor-related debris found at Tanis and discovered they would've arrived in multiple waves depending on their ejection angles. Debris would have fallen starting 13 minutes after impact and continued for roughly two hours. The fact that the tektite impacts are preserved in the same fossil beds and from the same time periods is one way researchers know the events occurred virtually simultaneously.



Image courtesy of Professor David Burnham, University of Kansas

The fish that inhabited the warm waters of the Western Interior Seaway, as this area of Montana was once known, wouldn't have had time to notice, on account of being aggressively killed. The Chicxulub impact may have set off a global earthquake a thousand times stronger than anything humans have ever experienced, causing what's known as a seiche -- a standing wave in a body of water -- in the waters that covered the Tanis area. The seiche could have produced 35-foot waves -- more than enough to inundate the local area. Many of the trees DePalma has found in the chaotic, mixed fossil bed have trapped spherules of meteorite debris in amber along their branches. Impact glass preserved in this fashion has been compared with deposits retrieved from the Chicxulub impact and found to be nearly identical.

Tektites-Gills-Fish

Image courtesy of Professor David Burnham, University of Kansas

The fish fossils, meanwhile, have microtektites in their gills. The image is hard to shake. Minutes after the asteroid struck, the low-lying area would have been rocked by waves, even as the sky began to rain fire. As the lunatic sea pitched and heaved, trees would have toppled into the water or exploded in flame. Beneath the water, fish choked to death on stone, unable to breathe in the flood of sediment. The entire site is an absurd jumble of creatures -- exactly what you might expect to see if the earth heaved, the sky fell, and a whole lot of unexpected ecological mixing suddenly occurred. Here's the New Yorker:

DePalma listed some of the other discoveries he's made at the site: several flooded ant nests, with drowned ants still inside and some chambers packed with microtektites; a possible wasp burrow; another mammal -burrow, with multiple tunnels and galleries; shark teeth; the thigh bone of a large sea turtle; at least three new fish species; a gigantic ginkgo leaf and a plant that was a relative of the banana; more than a dozen new species of animals and plants; and several other burrow types.



Combining the timing of the event at Tanis, the known Chicxulub impact, and the state of the actual deposit, DePalma and his fellow researchers, including Professor David Burnham from the Department of Geology at the University of Kansas, have constructed a remarkable timeline for the site. The preservation of the tektites and their impacts, combined with the jumbled, chaotic, and quickly deposited fossil layers, indicates these two events occurred at the same time. And while other paleontologists and researchers will need to confirm this -- expect the debate to rage for years -- it means we may have found a precise geologic record of what happened within the very first hours on the day the Cretaceous ended and the Paleogene began.

The New Yorker piece notes that DePalma may have a reputation for overpromising and under-delivering, but also leaves room for the fact that his discovery may be as earth-shaking as he claims. A precisely dated fossil record of the actual impact event, even in just one area, could answer numerous questions about the conditions on Earth after the asteroid hit. If these findings bear out, it's a discovery as profound as the identification of the Chicxulub Crater in the first place.

Now Read:

Dinosaur-Killing Impact Crater Shows Rock Can Flow Like FluidDinosaur-Killing Impact May Have Superheated Earth's Atmosphere for 100,000 YearsThe Extinction Event That Wiped Out the Dinosaurs Almost Didn't Happen

https://www.extremetech.com/extreme/288704-we-may-have-found-fossils-from-the-dinosaurs-last-moments-on-earth