Health

January 7, 2019

Let’s talk about the V

This post has been created in partnership with AZO Complete Feminine Balance®, but all opinions are my own.

A couple of disclosures:

1. I am not a specialist in genitourinary health. My statements and opinions are based on my own research, analysis, and patient reviews. These statements have not been evaluated by the FDA and this product is not intended to diagnose, treat, cure, or prevent any disease.
2. No one should read this and assume this information applies to everyone. Each patient is different, and any decision to start a new medication OR supplement, should be made individually with your doctor.

It’s not everyday you find a blog post discussing the V. Yah, that’s right, I mean the vagina. It’s not as scary when you say it out loud three times!

I love talking about medicine, health, and wellness. I really have NO shame. I can’t! I have pretty much seen it all, in the Emergency Department. Ladies, we all know how confusing the information about women’s health can be. So when I get an opportunity to learn about a product and educate all of YOU, I get excited! As an Emergency Medicine Physician, I see female patients and perform pelvic exams regularly. As a female of course, I also get my required pelvic exams from my physician. So I get it. And let’s be honest, none of us enjoy those exams. **Insert eye roll here**.

So what is AZO anyways? You may have heard of the brand, or seen it in drugstores when shopping around. The AZO brand has a complete line of urinary, vaginal, and bladder health products.

AZO Complete Feminine Balance® Daily Probiotic was created to help protect vaginal health, and restore and maintain the natural balance of good bacteria and yeast. The vagina is home to a host of live yeast and bacteria colonies, AKA the vaginal microbiome. When it’s in balance, everything is all good! It’s like your vagina’s own little defense system. Unfortunately, all of life’s happenings such as your period, pregnancy, or stress can disrupt its delicate balance, leaving you with infection and discomfort. Awkward!

AZO Complete Feminine Balance® Daily Probiotic contains Intellaflora^TM, otherwise known as a four strain blend of the most dominant lactobacilli in the vaginal microflora. Not all probiotics are equal, as bacteria is different in all different parts of the body. This probiotic was designed specifically for vaginal health and pH balance. AZO in particular, can work in up to 7 days^§, and is safe and effective for pregnant women.

Now let’s talk about what our lady parts are susceptible to. I commonly see vaginal infections that bring a wide range of symptoms that can be very bothersome.

The most frequent question I get is- “what am I doing wrong”? The answer little lady; often times nothing! Every woman’s body is different. There are many factors that play a role in contracting infections. Adding AZO Complete Feminine Balance^®daily probiotic helps support natural defenses to specifically maintain vaginal health. Keep in mind: AZO is not marketed as a specific treatment for these infections. But always consult your doctor if you feel it’s necessary.

We really are complex, ladies. Men have always been right… it’s just not our fault!

I’ve given you the science, and now I’ll give you my clinical experience. I see a variety of patients in the Emergency Department. Many of these patients are women who come in with genitourinary complaints. I have the same conversations with each of them- history, surgeries, medications, etc. A large amount of these patients, when asked about supplements, have endorsed using a number of AZO products. I would say it is the most popular brand used by my patients who present for genitourinary complaints. I have always been curious about patient results when using these probiotics, and many endorse them for maintenance of their vaginal health.

Ladies, if you are out there thinking and wondering if there’s an answer for you, ask your doctor about AZO Complete Feminine Balance^®. Again, this is an individualized decision that should be made with a medical professional. Keep in mind this is true especially if you are immunocompromised or have chronic medical conditions.

To my medical providers who are reading this- patients WILL ask you about this product. Educate yourself, try it out if you feel it’s a good option for you, and be open to what is out there outside of the medications you learn about in your pharmacology class and from your textbooks. This is super important in order to relate to your patients.

To my non-medical community- hopefully after reading this you feel a little less embarrassed by the taboo out there that surrounds the vagina, pelvic exams, and how us ladies can keep ourselves “in check” down there.

Click HERE for $5 off AZO products.

AZO Complete Feminine Balance® and Intellaflora ^TM are trademarks of DSM.

§Results demonstrated in clinical studies.

Career

June 4, 2018

My zombie life on night shift

It’s no surprise to you all, that I work a lot of night shifts. You see my regular post-night shift rituals that include attempting to beautify myself to no avail, and being a wide range of delirious, confused, slap happy, and just plain zombie.

As an Emergency Medicine physician, my schedule changes on the reg. Although schedule will always vary by the group or hospital that you work for, most Emergency Med docs will work night shifts. It is less likely to find a group where you work the same shift and have a regimented schedule. I actually prefer the variety. I don’t think I could work purely night shift, like nurses do. I want to be a day person and a night person! But at the same time, I imagine the regimented schedule (even if it is night shift) is just better for your body, over switching constantly.

You guys ask me constantly about my routines, schedule, tips and tricks, etc. Well here it (finally) is!

First things first… it took me a year (my entire intern year) to get my body used to NOT having a schedule. I was tired and felt very low energy ALL the time, for about a year. I tried routine after routine, before I figured out what worked best for me.

So that being said, BE PATIENT. Figuring these things out, is not easy and it takes time. In fact, your body will tell you what it wants. You just have to listen.

My favorite “routines” (I say that lightly because nothing in my life is routine) may not work for you, just as yours may not work for me. So again, don’t try to fit yourself into someone else’s routine. My night shift is scheduled from 9pm to 5am. For many of you those times may be variable but here’s how I tackle these shifts!

When I’m going ON to a night shift, I utilize the day as I would any other day, with the exception of trying to sleep in as late as I want. I allow myself as much sleep as I feel I need, but I don’t force myself to stay up late the night before, just to try and sleep in and get acclimatized to the night shift. I tried that in residency and it didn’t work at all. So when I wake up on these days, I lounge HARDCORE. I almost always work out on these days, at some point, preferably in the morning because I want to wind down during the afternoon and evening, and catch a nap if I can. That being said, I never force myself to nap. I end up more frustrated than not. I never do anything busy or overly social on the day I am starting a night shift. This will cause me to be way too tired and feel as if my day was rushed.

On my first night shift I typically get pretty tired around 2am, since I’ve been up all day. I prefer to use coffee or tea about halfway through my night shift, for an extra push. Regardless of if I drink caffeine during the shift, I hit the pillow hard and fast when I get home and I have no trouble getting to sleep.

I go to bed immediately when I get home and I set my alarm for 8 hours later, if I am going onto another night shift. I do wake up multiple times (especially after my first night shift), that’s inevitable, but I force myself to get back in bed and try to sleep. I NEVER look at my phone during these times. I use the clock in my room to see the time.

When I get up from bed, I make coffee/breakfast and carry out the morning (except it’s like 3pm) like I would any other morning. My meals are similar as any other day and I actually prefer my biggest meal to be “lunch” which is Chris’ dinner, because I don’t like eating anything heavy later in the night. To be honest, I don’t typically work out on my night-sandwich days. I am tired and honestly can use the rest. Plus my mind is confused and the last thing I want to do is get up off the couch, knowing I have another night shift coming. Sometimes I will go on a walk with Chris, or do a quick Insanity workout, but that’s rare. I make these my rest days. Many people do better and have more energy with working out before a shift, but when I’m constantly switching, it just doesn’t feel good for me.

I typically do 2-3 night shifts in a row. I try to never do more than that. When I am coming OFF of a night shift I sleep when I get home however I only allow about 4 hours. I would honestly sleep all day if I didn’t set an alarm. I tend to book a workout class for this late morning/early afternoon so that I have a reason to get up. There is NO way I would do an independent workout on these days (I have tried so many times) so a class keeps me motivated. Even though I am super tired, limiting my sleep allows me to go to bed at a normal hour and get up at a normal time the next morning.

I used to try and stay up all day when transitioning off of night shifts, in residency. I always fell asleep, no matter what I did, and I typically lost my entire day. The routine I described in the paragraph above gives me a good chance at enjoying at least some of the day.

I honestly think that allowing myself to sleep long hours and veg on the couch without any to-do list on either of these days flanking my night shifts, helps me get through it. Sometimes I feel like crap and other days I’m ready to rock n roll! I just accept it. It’s the job I chose so I had to find a way to continue living while feeling my best.

I maintain my energy for all of this, by working out the majority of the other days I am not on night shifts and keeping my diet relatively clean. Seriously, when I turned 30 I swear I started having all these food intolerances. It got worse when I started flipping schedules constantly. I know what and what not to eat at this point, because it will make me feel tired or crampy or bloated- none of which I want to suffer through, while awake all night taking care of patients. I have also learned to limit social activities if night shifts are coming up in my week.

So there you have it! My not-so-perfect way of tolerating night shifts and still being a fairly normal zombie, er I mean person. We all know this lifestyle is not healthy, but I do the best I can with the career I chose. And crossing my fingers that my night shifts continue to decrease as I move up in the ranks! 🙂

My absolute must-haves for a good post-night shift sleep:

Black out blinds. Like the best ones you can find. They are worth whatever you have to pay
Eye mask or t-shirt. Even black out blinds don’t keep out all the light sometimes!
Ear plugs. Day time noise doesn’t stop for us night shifters. Gotta block it out!
Water at bedside with Ibuprofen if needed. I sometimes suffer from headaches when I can’t sleep well, and having this by my bedside makes me going back to sleep smoother since I don’t have to get up
A clear path to the bathroom. My kidneys are never on night shift… and tripping on something when half asleep, well that’s how you end up in the Emergency Department
Air conditioner or fan. We use a portable AC that can double as a cool fan. The noise helps me block out other noise that would wake me up, and temperature control is SO important

Fave products that bring me back to life:

Peter Thomas Roth 24K gold eye patches
Exfolikate cleanser and exfoliant
Fresh Lotus eye gel
Fresh Lotus Moisturizer
Tretinoin gel/cream (I use this every night to prevent aging, get this prescribed by your dermatologist)
A fresh dose of botox every few months (by none other than The Treatment’s Erin Jensen). I swear, a small dose helps me look just a tiny bit more awake

Photos by Zo’e Fraley, Shirt by Medthusiast, Scrubs by FIGS

Fitness

February 25, 2018

What everybody ought to know about my fitness routine

A day in the life of Dr. Majestic, doesn’t always include a traditional workout.

Being an Emergency Medicine physician comes with frequent schedule changes and trouble sleeping, much of the time. I have learned to be creative, when it comes to my workouts.

In residency, I avoided working out completely, because I was so tired. Much of my calorie burning came from running around the hospital. I would try my best to get to the gym on my days off, but they were few and far between. Plus, I preferred to spend my days off sleeping, or doing something social!

I actually stayed pretty skinny. I didn’t gain any weight in residency despite my lack of regular fitness routine. Even though I was eating hospital food, and late night snacks on my 12-hour night shifts. I considered myself lucky. But what was happening underneath it all, was definitely not a healthy lifestyle.

Fast forward 3 years… no more residency excuses!

Just Do Something

I still struggle with finding the perfect workout schedule.

I know I’m supposed to write down goals, and keep a schedule, and honor my committments. It just doesn’t work that way for me. One minute I’ll be planning on the gym, the next minute I fall asleep on the couch because I worked a night shift the day before. There were times when I would scrap the workout all together, but I have learned to just DO SOMETHING. I may not make it to the gym like I had planned, but instead I will do a home workout. As long as I am showing up for myself, my health, and my body.

Some of my favorite workouts

♦ Yoga

Yoga was something I had always practiced in college. I had really enjoyed learning the culture and poses. Once I got to medical school and residency, I didn’t have the time or the money for yoga classes. Instead of continuing my practice, I let it go.

Yoga was the first thing I picked back up, as soon as I could. I started going to CorePower Yoga sculpt classes, and I was IN LOVE. A heated yoga class that incorporates cardio AND weights? Sign me up! I know so many people that have accomplished their goals with yoga, in particular yoga sculpt. CorePower offers multiple class types and multiple locations, so I have bounced around to each of them, over the past couple of years.

The workout is fierce. Initially I think I am dying, but then I always feel SO GOOD after the class, and the inspiration and meditation moments associated with yoga are just what I need.

I practice yoga sculpt ~2 times weekly

More recently, I’ve gotten Chris to come with me and he has become quite the yogi!

♦ HIIT (high intensity interval training) workouts

I have a love/hate relationship with them. They are quite possibly my favorite workout because they can be quick! We’re talking 25-30 minutes of go-hard, sweaty, high intensity fitness. My go-to workout because it saves time and you can do them anywhere!

25-50% of my weekly workouts are HIIT routines

My fave HIIT workout has always been Insanity. Shaun T… you always piss me off!!! But damnit you get me the results!

Chris and I bought the BeachBody workouts for $99 a year! I am so not a fan of pyramid schemes- I don’t buy into the shakes or anything, just the on demand home workout option. This includes a huge library of workouts to choose from, including ALLLLL the Insanity you could ask for. The OG Insanity was my jam back in med school. I still tap into those workouts sometimes, but they are 60 min. The newer Insanity MAX and T25 workouts are right up my alley these days, especially when I’m on night shifts.

Very few of the workouts require weights, although you can find those too. I like using minimal equipment, body weight only, and I’m done before I even realize I started! Downfall to some of the HIIT workouts are the amount of impact they can have on your joints. Plyometrics isn’t for everyone, so make sure you tailor these to your body.

♦ Running

I have a seriously difficult time with running. When I was a kid, I never did the running sports. I was a dancer, cheerleader, volleyball and softball player. Soccer, track, basketball… forget it. Therefore, I never really became great at running, especially not long distance running.

In 2008 I trained for, and completed a half marathon. I thought I was going to die. I trained so hard, for weeks, and my joints still killed me for days after the race. I have only run 5-10K’s since then! I do enjoy many parts of running, especially here in Southern California. Living by the beach, I try to take advantage of the location and run down to the boardwalk and beach at least once weekly. You can’t beat an outdoor workout overlooking the ocean! #thankful

My goals with running, are simply to complete my run without stopping! Sometimes I do the walk-run thing, but I never stop moving. My typical route consists of 4-5 miles, and once I hit about 3 miles, my knees start to remind me that they’re not happy.

10-25% of my weekly workout is running

♦ Walking

In the past, I feel like I underestimated the benefits of a nice, long walk. Walking actually burns calories similar to running! Of course the terrain and pace determines your overall results, but it is such a GREAT option for many of us.

Chris and I try to get outside for a walk together at least once weekly

I definitely dread walking, less than any other workout! Gee, I wonder why?! We try to walk at a 11-12 min/mile pace, and complete no less than 5 miles. We love to walk the beach neighborhoods and surrounding areas. Not only are we getting some vitamin D, but it gives us quality time to be without technology, and catch up with each other!

We started walking together, after Chris had surgery last year. He couldn’t do his usual sweaty workouts because would affect his cast and wound healing, so we walked all of the time! We share airpods during the walk, so we can listen to the same music but still hear each other talk 🙂

The one thing not listed, is gym time.

That’s because I no longer go to a gym! I used to go to a beautiful gym that faced the ocean, it had state of the art equipment and great amenities. But what I realized about my fitness routine, was that I never really longed to be at the gym. I enjoyed all of the other activities listed above, so much more, and the gym was a waste of money for me.

If you take anything away from this blog post, it should be that fitness and exercise don’t need to come with a huge price tag OR a huge chunk of time. You can tailor your fitness routine to YOU and what you like to do. It does not need to be forced or dreadful. As soon as I realized this simple nugget of information, my anxiety associated with a fitness routine and working out hardcore everyday, miraculously dissolved.

So even if I have to get my fitness running around at work, or reducing dislocated shoulders and hips (that can really break a sweat sometimes), I do the best that I can and accept that my fitness routine will be ever-changing and dependent on many other life factors.

How is your fitness routine unique?

Photos by Zo’e Fraley.

Marriage/Family

February 7, 2018

In the spirit of love <3

I cannot believe Chris and I are engaged!!! To say I am excited to marry this man, is an understatement. I am simply ecstatic! We have received SO much love and well wishes from so many friends, family members, and all of YOU!

To kick off our engagement, we were lucky enough to have some friends of ours, who also happen to be marriage counselors, give us some amazing advice. Since February is the month of love and all… I wanted to share the words with you, as I know many of you out there are in relationships and can always use some inspiration!

Learn from your past
We all have junk in our past. The best thing each of partner can do is to acknowledge their junk, work through it, and grow from it into a better, healthier person. Anyone who thinks they can drag their junk into a new relationship and just bury it in the back of some closet is making a huge mistake. Lastly, sharing your junk with each other gives you both the chance to be honest, vulnerable, and authentic. This, in turn, fosters greater intimacy. In essence, your past junk can be leveraged to grow your future together. How awesome is that?!

Live in the present
We talk often about how important is is to be present for one another, to really be there in the moment. Everyone says, “Yeah, yeah, I know what that means,” but fewer couples know how to live out being present day in and day out. Let’s be honest, there is a great deal of stress at times in medicine and emergency services. When you choose to be present for each other, you are essentially saying, “There is nothing more important than me being here for you in this moment we have together.” This is how lifelong partners learn to stay well connected.

Plan for the future
Couples don’t plan for their marriages to fail, many times they merely fail to plan. Planning together in a marriage is really dreaming together. What will our life together look like in five years? Ten years? What kind of vacations would we enjoy together? How many kids (or dogs) will we have? Even when your spouse’s dreams are out of your comfort zone, dream anyway. Falling in love is easy, staying in love requires a plan.

Choose your spouse again every single day
We all have so many choices to make in life each day. Shouldn’t the first one be to choose each other all over again? It sounds elementary, but choosing each other every day takes effort. It takes intentionality. It takes two people who acknowledge that a great deal of things COULD come between them over the course of their life together, but they will refuse to let that happen by choosing each other every day.

Forgive readily
Your spouse will do things that drive you bonkers! No really, they will. Also, you will do things that make your spouse crazy. That’s exactly what grace and forgiveness are for. Grace says, “I don’t understand, but I choose to love you anyway.” Forgiveness says, “You don’t deserve a get-out-of-jail-free-card, but I’m going to give you one this time anyway for two reasons: first, because this weight is too heavy a grudge for me to carry, and second, because I hope to receive the same kind of forgiveness when (not if) I need it.” The two of us always say to give away grace and forgiveness like candy. This does not mean you allow yourself to be walked on. On the contrary, it means you are taking the higher ground and not letting your spouse’s shortcomings become your own burdens.

There will always be something in life worth fighting for: each other
It seems these days that everyone has a cause, let your cause be that of showing the world what selfless, committed love looks like. You will disagree, argue, and fight at times. When this happens, remind yourself of what is worth fighting for. Is it worth it to fight over who squeezes the toothpaste tube the wrong way or who leaves the toilet seat in the wrong position? HECK NO! Fight for each other. Always.

No plan B
Spouses who keep an exit strategy in their back pocket will be more likely to use it as a means to avoid doing the work required to stay together and grow. Besides, what’s so bad about doing some work to stay together? That’s how we grow in all things. We all remember the times we wanted to quit school. When we pressed through the rough spots, we grew and overcame. We became better and stronger. Marriage can be the same if we are not constantly looking for a reason to invoke Plan B.

Dance together, slowly and often
There is something intimate, sexy, and fun about slow dancing together. Each of you should be deliberately spontaneous at times to grab the other and dance. Shut the world out, look into each other’s eyes, remember why you fell in love, and just dance.

Be the person you want to be married to
Most spouses spend far too much time wishing their spouse would change and far too little time working on changing themselves for the better. This is tragic. Be in the habit of working on yourself first so that you are a better person in light of the whole, not in spite of it.

Surround yourselves with others who have the kind of relationship you want
We talk often about this idea of having marriage mentors. Surrounding yourselves with great marriages is the doorway to healthy marriage mentoring. A rising tide raises all ships. This can be true of marriage as well.

As I read each of these points, I couldn’t help but be even more excited to jump in and surround myself with all the relationship inspiration and literature that I can get! There’s just something about February and Valentine’s Day that really puts me in the spirit for love. And bring on alllll the red and pink!

Although Chris and I have a solid relationship, Brad and Tami’s advice brings up such crucial points. There will be so many obstacles in life that may bring about challenges, and no matter how easy and perfect your relationship is, it is SO important to know how to navigate through these challenges.

I look at marriage counseling and advice books as excellent resources. I used to be the type of person that wouldn’t reach out for more information, unless I felt there was a problem. Well I feel totally different now. Life is hard. Shit gets real. Bad things happen. And I’m going to do everything in my power to be prepared for those hard times! Geez… practice emergency medicine much, Cassie? Can we say prepared to paranoia status?

In all seriousness, I am psyched to be kicking off my engagement with so much love and happiness around me. Thank you all so so much for being such a great source of support regularly!

You can learn more about our friends, Brad and Tami, here. And if you want daily relationship inspiration (I am SUCH a sucker for the daily inspirational quotes!!), you can find them on IG @tandemmarriage.

Get To Know Me

Join the List

Join the List