Scared Sexless (my latest "Ask Dr Peg" column)

Dear Doctor Peg,

I’m freaking out. I went to a great party last night, and had a fantastic time, but, well, I guess I had too much to drink, and there was this really attractive person, and one thing led to another, and we had sex. We didn’t use protection. This morning I’m sober, I have a roaring headache, I feel like an idiot, and I’m terrified. What have I done? What could happen to me? I can’t believe I did that. I’m never having sex again!

Scared Sexless

Dear Scared,

What have you done, you ask? You made some choices that put your health at risk. You are clearly regretting this as you look back with the clarity of hindsight. What could happen to you? That depends on a few things.

If you are Scared Susie, you’ll be worrying about disease and pregnancy (unless you had sex with a woman, in which case you’ll still be worrying about disease). If you are Scared Sam, it’s the possibility of disease that’s making your headache worse. Let’s take these issues one at a time.

Pregnancy. For pregnancy prevention, come to the Student Health Center for Emergency Contraception. You need a prescription for this hormone treatment, but soon it will be available over the counter. The sooner you take ECP the better, but it can be effective up to three days after unprotected sex. ECP is not an abortion pill. While you’re at the SHC, you can get more information about birth control methods.

STI’s. This is the new and improved acronym for Sexually Transmitted Infections (formerly ST Diseases). There are several. For practical purposes, I’m going to divide them into two categories, curable and incurable.

Curable STI’s. These are infections that can be cured with antibiotics, after which they are gone from your body for good, unless you catch them again. Please note that most of these can be “silent,” meaning you can have them and not know it. We can find them for you, though, with blood, urine or swab tests. When they do cause symptoms, they are typically as follows. Trichomonas, or “trich” (pronounced “trick”) is a parasite that can cause an itchy, smelly, greenish discharge from the penis or vagina. Chlamydia is a bacterium that can cause burning with urination, a penile or vaginal discharge, painful sex or vaginal bleeding. We see several cases of Chlamydia at Student Health every year, especially after Spring Break. GonorrheaPubic lice (“crabs”) cause severe itching and rash in the pubic area. If you look closely, you might be able to see the lice themselves or their egg cases on your pubic hair. Crabs are treated topically with a cream or liquid. Molluscum contagiosum virus causes bumps that look and feel like hard pimples. Removing the core of each lesion, which we do in the clinic, helps the infection clear up more quickly. (“the drip”) causes a goopy, yellow discharge from the penis or vagina.

Incurable STI’s. For this group of infections, modern medicine has no cure. We can give you drugs to make you feel better, or to decrease the intensity and duration of your symptoms, but we can’t kill the viruses. Herpes causes exquisitely tender sores, in your mouth or on your genitals. Human Papilloma Virus (HPV) causes warts on your genitals, and some strains can cause cancer of the cervix. The good news about HPV is that there is now a vaccine that will protect you from the most dangerous strains. If you get genital warts, we’ll freeze them off, but unfortunately that doesn’t get rid of the virus, which usually lives about two more years under your skin. Hepatitis B, for which there is also a vaccine, can be silent or cause an illness with nausea, fever and bodyaches. And finally, HIV, which has a variety of symptom presentations and for which there is no known cure at this time.

I know that is quite the parade of scoundrels, and I’ve probably scared you worse by listing them all. However, chances are very slim that you’d have more than one or two of these after your wild escapade last night, and it’s likely that you don’t have any of them. The problem is, it can take weeks to months for these infections to show up in your body after you catch them.

So how long should you wait to be seen by a health professional? If you’re Susie, don’t wait for pregnancy prevention. Anyone else, make an appointment for “STI Screeing” with one of the SHC practitioners or the Women’s Health department. We will listen to you, examine you, educate you, and advise you. We might do labwork to find out if you’re positive for any of these STI’s now. We can tell you when to come back and get tested the next time. If you develop symptoms before your scheduled visit, come to the Walk-In clinic or make another appointment to be checked.

Finally, go easy on yourself. Everyone makes mistakes. Everyone does stupid things. You don’t have to swear off sex forever, or brand a big L for Loser on your forehead. Just take steps to be healthy now, and in the future, if you choose to have sex with a stranger, please, protect yourself.

Balloons!

It's time for the annual Albuquerque International Balloon Fiesta. Every October hundreds of balloonists gather here, and the skies fill with color for a week. So far this week they've been thwarted by rain or wind most days, but today the sun came out and up they went.

These pics are actually from last year, taken from my house and from the park across the street. I'm too lazy to brave the crowds at Balloon Park and besides, why should I, with views like this? If they land right in front of my nose again this year, I'll add fresh pics.

It's a fun reason to come to Albuquerque, if you ever need one!

The Scoop on Coffee

This is an article I wrote for our University newspaper, in response to a question someone sent in about coffee. They wanted to know if it is good or bad for them, whether it is true that coffee after heavy drinking protects the liver, and what about energy drinks? They said "like Tom Petty I have a Need To Know."

Dear Coffee Cat,

If you’ve heard good and bad things about coffee, you’re paying attention. And if you’re confused, there’s good reason, because the truth is, it’s both. Allow me to explain.

How is coffee good for you?

1. It stimulates the brain. We all know that. It’s the whole reason many people indulge. And face it: even though you are smart enough to have gotten into college, there are those times when your brain could use a little extra boost. When that big paper is due tomorrow and you’re farther behind than you thought. When it’s the “morning after the night before,” and you need to function at work. At times like these, an extra mental lift can be highly useful. There is also some evidence that regular coffee drinkers have less “age related cognitive decline” than non-coffee drinkers. In other words, they kept their “marbles” longer into their old age. (The same study, by the way, found these benefits and more with green tea.)

2. I’m glad you brought up the liver thing. It gives me a chance to debunk some rumors. The answer to your question is no, coffee cannot heal the liver after a long night of drinking. Coffee can’t sober you up either, contrary to popular misconception. The only thing that will get alcohol out of your blood is time, sweet time. What may be true is that – now, read this carefully – people who drink alcohol heavily, and we’re talking heavily and long enough to cause cirrhosis of the liver, can get some protective effect for their liver over the years by drinking coffee too. This is not the same thing as saying that if you binge drink all night, you can reverse the beating you gave your poor liver by going out for a latte in the morning. No. If you really want to protect your liver from cirrhosis, a far better way to do that is not to drink too much alcohol in the first place.

3. Finally, coffee is often at the center of meaningful social interaction. Relaxing with a friend and having a real conversation while you sip your caffeinated beverage of choice is, in my opinion, a ritual worth honoring.

How is coffee bad for you?

1. Too much coffee can give you uncomfortable jitters, headaches, anxiety, insomnia, and stomach and bladder irritation. Coffee aggravates the painful fibrocystic breast condition. It can affect the kidneys, acting as a diuretic (makes you pee). Coffee can increase your pulse and your blood pressure and contribute to ulcers. It can worsen PMS (now that is truly frightening!). All of these side effects are what we medical types call “dose related responses.” In other words, the more coffee you drink, the more likely you’ll suffer.

2. Is coffee addictive? Oh, yes. If you’ve ever been a regular coffee drinker and tried to quit, you know what I’m talking about. Headaches, drowsiness, lack of concentration and focus…those, my friend, are withdrawal symptoms. Withdrawal from caffeine, the drug of choice of millions of Americans. Whether we’re “guzzling coffee like crazy fools,” taking “big gulps”of sodas or sipping tea, we consume tons of caffeine-containing products each year. If you want to jettison your caffeine addiction, I suggest you cut your consumption in half for a week, then quit. Be prepared to feel lousy for another week, but then you should be fine.

There are some “positive negatives” to the coffee story. In other words, some bad things that coffee does not do. It does not cause cancer. It does not increase your heart disease risk. In moderation, coffee and other forms of caffeine do not have significant health risks. How much is “moderation? That depends on the person. Different people have different caffeine sensitivities. For the average Joe, 2-3 cups of “Joe” a day counts as moderate consumption.

Finally, you asked about energy drinks. Those little power cans vary widely in their ingredients, including the amount of caffeine and other stimulants. Some have a lot of sugar. Some use artificial sweeteners. Most use artificial flavors and colors. Most have less caffeine than a cup of coffee, yet cost more. Since the full health effects of food additives are not yet completely known, I myself am more inclined toward the natural stuff, meaning “the bean” or “the [tea] leaf.”

I hope this satisfies your Need To Know, Coffee Cat. Now tomorrow when it’s Wakeup Time you can enjoy your java with No Second Thoughts.