Friday, June 19, 2009

AMA objects to calling obesity a disability

CHICAGO – The American Medical Association has taken action to support doctors’ ability to discuss obesity with their overweight patients.

Under a new policy adopted Tuesday, the AMA formally opposes efforts by advocacy groups to define obesity as a disability.

Doctors fear using that definition makes them vulnerable under disability laws to lawsuits from obese patients who don’t want their doctors to discuss their weight.

Doctors took the action at their annual meeting in Chicago.

In other action Tuesday, the AMA agreed to lobby for legislation to ban selling tobacco in pharmacies.

Health care reform issues are slated to come up later at the meeting, which ends Wednesday.

Posted by A.F.Garcia,MD,CFP in 03:51:57 | Permalink | Comments Off

Tuesday, April 28, 2009

What you need to know about swine flu

By LAURAN NEERGAARD, AP Medical Writer Lauran Neergaard, Ap Medical Writer 1 hr 26 mins ago

WASHINGTON – A never-before-seen strain of swine flu has turned killer in Mexico and is causing milder illness in the United States and elsewhere. While authorities say it’s not time to panic, they are taking steps to stem the spread and also urging people to pay close attention to the latest health warnings and take their own precautions.

“Individuals have a key role to play,” Dr. Richard Besser, acting chief of the Centers for Disease Control and Prevention, said Monday.

Here’s what you need to know:

Q: How do I protect myself and my family?

A: For now, take commonsense precautions. Cover your coughs and sneezes, with a tissue that you throw away or by sneezing into your elbow rather than your hand. Wash hands frequently; if soap and water aren’t available, hand gels can substitute. Stay home if you’re sick and keep children home from school if they are.

Q: How easy is it to catch this virus?

A: Scientists don’t yet know if it takes fairly close or prolonged contact with someone who’s sick, or if it’s more easily spread. But in general, flu viruses spread through uncovered coughs and sneezes or — and this is important — by touching your mouth or nose with unwashed hands. Flu viruses can live on surfaces for several hours, like a doorknob just touched by someone who sneezed into his hand.

Q: In Mexico, officials are handing out face masks. Do I need one?

A: The CDC says there’s not good evidence that masks really help outside of health care settings. It’s safer just to avoid close contact with someone who’s sick and avoid crowded gatherings in places where swine flu is known to be spreading. But if you can’t do that, CDC guidelines say it’s OK to consider a mask — just don’t let it substitute for good precautions.

Q: Is swine flu treatable?

A: Yes, with the flu drugs Tamiflu or Relenza, but not with two older flu medications.

Q: Is there enough?

A: Yes. The federal government has stockpiled enough of the drugs to treat 50 million people, and many states have additional stocks. As a precaution, the CDC has shipped a quarter of that supply to the states to keep on hand just in case the virus starts spreading more than it has so far.

Q: Should I take Tamiflu as a precaution if I’m not sick yet?

A: No. “What are you going to do with it, use it when you get a sniffle?” asks Dr. Marc Siegel of New York University Langone Medical Center and author of “Bird Flu: Everything you Need To Know About The Next Pandemic.” Overusing antiviral drugs can help germs become resistant to them.

Q: How big is my risk?

A: For most people, very low. Outside of Mexico, so far clusters of illnesses seem related to Mexican travel. New York City’s cluster, for instance, consists of students and family members at one school where some students came back ill from spring break in Mexico.

Q: Why are people dying in Mexico and not here?

A: That’s a mystery. First, understand that no one really knows just how many people in Mexico are dying of this flu strain, or how many have it. Only a fraction of the suspected deaths have been tested and confirmed as swine flu, and some initially suspected cases were caused by something else.

Q: Should I cancel my planned trip to Mexico?

A: The U.S. did issue a travel advisory Monday discouraging nonessential travel there.

Q: What else is the U.S., or anyone else, doing to try to stop this virus?

A: The U.S. is beginning limited screening of travelers from Mexico, so that the obviously sick can be sent for treatment. Other governments have issued their own travel warnings and restrictions. Mexico is taking the biggest steps, closings that limit most crowded gatherings. In the U.S., communities with clusters of illness also may limit contact — New York closed the affected school for a few days, for example — so stay tuned to hear if your area eventually is affected.

Q: What are the symptoms?

A: They’re similar to regular human flu — a fever, cough, sore throat, body aches, headache, chills and fatigue. Some people also have diarrhea and vomiting.

Q: How do I know if I should see a doctor? Maybe my symptoms are from something else — like pollen?

A: Health authorities say if you live in places where swine flu cases have been confirmed, or you recently traveled to Mexico, and you have flulike symptoms, ask your doctor if you need treatment or to be tested. Allergies won’t cause a fever. And run-of-the-mill stomach bugs won’t be accompanied by respiratory symptoms, notes Dr. Wayne Reynolds of Newport News, Va., spokesman for the American Academy of Family Physicians.

Q: Is there a vaccine to prevent this new infection?

A: No. And CDC’s initial testing suggests that last winter’s flu shot didn’t offer any cross-protection.

Q: How long would it take to produce a vaccine?

A: A few months. The CDC has created what’s called “seed stock” of the new virus that manufacturers would need to start production. But the government hasn’t yet decided if the outbreak is bad enough to order that.

Q: What is swine flu?

A: Pigs spread their own strains of influenza and every so often people catch one, usually after contact with the animals. This new strain is a mix of pig viruses with some human and bird viruses. Unlike more typical swine flu, it is spreading person-to-person. A 1976 outbreak of another unusual swine flu at Fort Dix, N.J., prompted a problematic mass vaccination campaign, but that time the flu fizzled out.

Q: So is it safe to eat pork?

A: Yes. Swine influenza viruses don’t spread through food.

Q: And whatever happened to bird flu? Wasn’t that supposed to be the next pandemic?

A: Specialists have long warned that the issue is a never-before-seen strain that people have little if any natural immunity to, regardless of whether it seems to originate from a bird or a pig. Bird flu hasn’t gone away; scientists are tracking it, too.

For more info logon to
U.S. government flu info: http://pandemicflu.gov/faq/swineflu/

Posted by A.F.Garcia,MD,CFP in 10:16:05 | Permalink | Comments (1) »

WHO raises its pandemic alert level on swine flu

MEXICO CITY – The World Health Organization raised its global alert level on the spreading swine flu virus Monday, but stopped short of declaring a global emergency — even as the U.S. said it was acting as if the outbreak would grow into a full pandemic.

The United States advised Americans against most travel to Mexico and ordered stepped up border checks in neighboring states. The European Union health commissioner advised Europeans to avoid nonessential travel both to Mexico and parts of the United States.

The suspected number of deaths rose to 149 in Mexico, the epicenter of the outbreak with nearly 2,000 people believed to be infected.

The number of U.S. cases doubled to 40, the result of further testing at a New York City school, although none was fatal. Other U.S. cases have been reported in Ohio, Kansas, Texas and California. Worldwide there were 73 cases, including six in Canada, one in Spain and two in Scotland.

While the total cases were still measured in hundreds, not thousands, Mexican Health Secretary Jose Angel Cordova said the epidemic was entering an extremely dangerous phase, with the number of people coming down with the disease mushrooming even as authorities desperately ramped up defenses.

“We are in the most critical moment of the epidemic. The number of cases will keep rising, so we have to reinforce preventative measures,” Cordova said at a news conference.

The WHO raised the alert level to Phase 4, meaning there is sustained human-to-human transmission of the virus causing outbreaks in at least one country.

Its alert system was revised after bird flu in Asia began to spread in 2004, and Monday was the first time it was raised above Phase 3.

“At this time, containment is not a feasible option,” as the virus has already spread to several other countries, said WHO Assistant Director-General Keiji Fukuda.

Putting an alert at Phases 4 or 5 signals that the virus is becoming increasingly adept at spreading among humans. That move could lead governments to set trade, travel and other restrictions aimed at limiting the disease’s spread.

The WHO’s Phase 6 is the pandemic phase, characterized by outbreaks in at least two regions of the world.

Many experts think it may be impossible to contain a flu virus already spreading in several countries.

Russia, Hong Kong and Taiwan said they would quarantine visitors showing symptoms of the virus amid global fears of a pandemic, an epidemic spread over a large area, either a region or worldwide.

President Barack Obama said the outbreak was reason for concern, but not yet “a cause for alarm.”

Dr. Richard Besser, acting director of the Centers for Disease Control and Prevention, said that so far the virus in the United States seems less severe than in Mexico. Only one person has been hospitalized in the U.S.

“I wouldn’t be overly reassured by that,” Besser told reporters at CDC’s headquarters in Atlanta, raising the possibility of more severe cases in the United States.

“We are taking it seriously and acting aggressively,” Besser said. “Until the outbreak has progressed, you really don’t know what it’s going to do.”

U.S. customs officials began checking people entering U.S. territory. Millions of doses of flu-fighting medications from a federal stockpile were on their way to states, with priority given to the five already affected and to border states. Federal agencies were conferring with state and international governments.

“We want to make sure that we have equipment where it needs to be, people where they need to be and, most important, information shared at all levels,” said Janet Napolitano, head of the Homeland Security Department.

“We are proceeding as if we are preparatory to a full pandemic,” Napolitano said.

She said travel warnings for trips to Mexico would remain in place as long as swine flu is detected.

Mexico canceled school at all levels nationwide until May 6, and the Mexico City government said it was considering a complete shutdown, including all public transportation, if the death toll keeps rising. Labor Secretary Javier Lozano Alarcon said employers should isolate anyone showing up for work with fever, cough, sore throat or other signs of the flu.

Amid the warnings, the Mexican government grappled with increasing criticism of its response. At least two weeks after the first swine flu case, the government has yet to say where and how the outbreak began or give details on the victims.

The health department lacked the staff to visit the homes of all those suspected to have died from the disease, Cordova said.

Cordova said 1,995 people have been hospitalized with serious cases of pneumonia since the first case of swine flu was reported April 13. The government does not yet know how many were swine flu. Of those who have died, 20 have been confirmed to be from swine flu and the government was awaiting results on the others.

As if the country did not have enough to deal with, Cordova’s comments were briefly interrupted by a 5.6-magnitude earthquake in southern Mexico that rattled already jittery nerves and sent mask-wearing office workers into the streets of the capital.

Aside from the confirmed cases, 13 are suspected in New Zealand, and one is suspected in both France and Israel.

European Union Health Commissioner Androulla Vassiliou advised Europeans to avoid nonessential travel to Mexico and parts of the United States, although Besser said that including the U.S. in the advisory seemed unwarranted at this time.

State Department spokesman Robert A. Wood said Vassiliou’s remarks were his “personal opinion,” not an official EU position, and therefore the department had no comment.

“We don’t want people to panic at this point,” Wood said.

The U.S. stepped up checks of people entering the country by air, land and sea.

Besser said a new U.S. travel advisory was being prepared suggesting “nonessential travel to Mexico be avoided.”

The best way to keep the disease from spreading, he said, is by taking everyday precautions such as frequent handwashing, covering up coughs and sneezes and staying away from work or school if not feeling well. He said authorities are not recommending that people wear masks at work because evidence that it is effective “is not that strong.”

Besser said about 11 million doses of flu-fighting drugs from a federal stockpile have been sent to states in case they are needed. That’s roughly one quarter of the doses in the stockpile, he said.

There is no vaccine available to prevent the specific strain now being seen, he said, but some antiflu drugs do work once someone is sick.

If a new vaccine eventually is ordered, the CDC already has taken a key preliminary step — creating what’s called seed stock of the virus that manufacturers would use.

Many of the cases outside Mexico have been relatively mild. Symptoms include a fever of more than 100, coughing, joint aches, severe headache and, in some cases, vomiting and diarrhea.

European and U.S. markets bounced back from early losses as pharmaceutical stocks were lifted by expectations that health authorities will increase stockpiles of anti-viral drugs. Stocks of airlines, hotels and other travel-related companies posted sharper losses.

WHO spokesman Peter Cordingley singled out air travel as an easy way the virus could spread, noting that the WHO estimates that up to 500,000 people are on planes at any time.

Governments in Asia — with potent memories of previous flu outbreaks — were especially cautious. Singapore, Thailand, Japan, Indonesia and the Philippines dusted off thermal scanners used in the 2003 SARS crisis and were checking for signs of fever among passengers from North America. South Korea, India and Indonesia also announced screening.

In Malaysia, health workers in face masks took the temperatures of passengers as they arrived on a flight from Los Angeles.

China said anyone experiencing flu-like symptoms within two weeks of arrival had to report to authorities.

China, Russia and Ukraine were among the countries banning imports of pork and pork products from Mexico and three U.S. states that have reported swine flu cases, while other countries, such as Indonesia, banned all pork imports.

The CDC says people cannot get the flu by eating pork or pork products.

Germany’s leading vacation tour operators were skipping stops in Mexico City as a precaution. The Hannover-based TUI said trips through May 4 to Mexico City were being suspended, including those operated by TUI itself and also through companies 1-2 Fly, Airtours, Berge & Meer, Grebeco and L’tur.

Japan’s largest tour agency, JTB Corp., suspended tours to Mexico through June 30.

Russian travel agencies said about a third of those planning to travel to Mexico in early May had already canceled

Posted by A.F.Garcia,MD,CFP in 05:43:38 | Permalink | Comments (1) »

Monday, April 13, 2009

Aging: What to expect as you get older

Find out what’s considered a normal part of the aging process.

By Mayo Clinic staff

Looked in the mirror lately only to find a few more wrinkles and gray hairs? Those are just a few of the changes you’re likely to notice as you get older. But what exactly is going on with your body? Here’s a list of the natural changes you can expect as you age.

Cardiovascular system

Over time, your heart muscle becomes less efficient, working harder to pump the same amount of blood through your body. In addition, your blood vessels lose elasticity. Hardened fatty deposits may form on the inner walls of your arteries (atherosclerosis), narrowing the vessels. The natural loss of elasticity, in combination with atherosclerosis, makes your arteries stiffer, causing your heart to work even harder to pump blood through them. This can lead to high blood pressure (hypertension).

Bones, muscles and joints

Your bones reach their maximum mass between ages 25 and 35. As you age, your bones shrink in size and density. One consequence is that you might become shorter. Gradual loss of density weakens your bones and makes them more susceptible to fracture. Muscles, tendons and joints generally lose some strength and flexibility as you age.

Digestive system

Swallowing and the motions that automatically move digested food through your intestines slow down as you get older. The amount of surface area within your intestines diminishes slightly. The flow of secretions from your stomach, liver, pancreas and small intestine may decrease. These changes generally don’t disrupt your digestive process, so you may never notice them. But you might notice more constipation.

Kidneys, bladder and urinary tract

With age, your kidneys become less efficient in removing waste from your bloodstream. Chronic conditions such as diabetes or high blood pressure and some medications can damage your kidneys further.

About one in 10 people age 65 and older has experienced a loss of bladder control (urinary incontinence). Incontinence can be caused by a number of health problems, such as obesity, frequent constipation and chronic cough.

Women are more likely than men to have incontinence. Women who’ve been through menopause might experience stress incontinence as the muscles around the opening of the bladder (sphincter muscles) lose strength and bladder reflexes change. As estrogen levels decline, the tissue lining the tube through which urine passes (urethra) becomes thinner. Pelvic muscles become weaker, reducing bladder support.

In older men, incontinence is sometimes caused by an enlarged prostate, which can block the urethra. This makes it difficult to empty your bladder and can cause small amounts of urine to leak.

Brain and nervous system

The number of cells (neurons) in your brain decreases with age, and your memory becomes less efficient. However, in some areas of your brain, the number of connections between the cells increases, perhaps helping to compensate for the aging neurons and maintain brain function. Your reflexes tend to become slower. You also tend to become less coordinated and may have difficulty with balance.

Eyes

With age, your eyes are less able to produce tears, your retinas thin, and your lenses gradually turn yellow and become less clear. In your 40s, focusing on objects that are close up may become more difficult. Later, the colored portions of your eyes (irises) stiffen, making your pupils less responsive. This can make it more difficult to adapt to different levels of light. Other changes to your lenses can make you sensitive to glare, which presents a problem when driving at night. Common conditions that affect aging eyes include cataracts, glaucoma and macular degeneration.

Ears

Hearing loss is one of the most common conditions affecting adults who are middle-aged and older. About half of all people older than age 85 experience hearing loss. Over the years, noises can damage the sensory hair cells of your inner ears.

Also, the walls of your auditory canals thin, and your eardrums thicken. You may have difficulty hearing high frequencies. Some people find it difficult to follow a conversation in a crowded room. Changes in the inner ear or in the nerves attached to it, earwax buildup and various diseases can all affect your hearing.

Teeth

How your teeth and gums respond to age depends on how well you’ve cared for them over the years. But even if you’re meticulous about brushing and flossing, you may notice that your mouth feels drier and your gums have pulled back (receded). Your teeth may darken slightly and become more brittle and easier to break.

Most adults can keep their natural teeth throughout their lives. But with less saliva to wash away bacteria, your teeth and gums become slightly more vulnerable to decay and infection. If you’ve lost most or all of your natural teeth, you might use dentures or dental implants as a replacement.

Some older adults experience dry mouth (xerostomia), which can lead to tooth decay and infection. Dry mouth can also make speaking, swallowing and tasting difficult. Oral cancer is more common among older adults. Your dentist checks for oral cancer when you go for regular cleanings and checkups.

Skin, nails and hair

With age, your skin thins and becomes less elastic and more fragile. You’ll likely notice that you bruise more easily. Decreased production of natural oils may make your skin drier and more wrinkled. Age spots can occur, and small growths called skin tags are more common. Your nails grow at about half the pace they once did. Your hair may gray and thin. In addition, you likely perspire less — making it harder to stay cool in high temperatures and putting you at increased risk of heat exhaustion and heat stroke.

How fast your skin ages depends on many factors. The most significant factor is sun exposure over the years. The more sun your skin has been exposed to, the more damaged it may be. Smoking adds to skin damage, such as wrinkles. Skin cancer also is a concern. Your risk of skin cancer increases as you age.

Sleep

Sleep needs change little throughout adulthood. If you need six hours of sleep nightly, chances are you’ll always need six hours — give or take 30 minutes. However, as you age, you’ll likely find that you sleep less soundly, meaning you’ll need to spend more time in bed to get the same amount of sleep. By age 75, some people wake up several times each night.

Weight

As you age, maintaining a healthy weight — or losing weight if you’re overweight — may be more difficult. Your metabolism generally slows, meaning that your body burns fewer calories. Calories that were once used to meet your daily energy needs instead are stored as fat. Your level of activity may decrease, resulting in unwanted weight gain.

Sexuality

With age, sexual needs, patterns and performance may change. Women’s vaginas tend to shrink and narrow, and the walls become less elastic. Vaginal dryness is a problem. All of this can make sex painful.

Impotence becomes more common in men as they age. By age 65, as many as one in four men has difficulty getting or keeping an erection. In others, it may take longer to get an erection, and it may not be as firm as it used to be.

Healthy changes can improve quality of life as you age

If you think you’ve already done too much damage to yourself to hope for a long life, think again. Researchers say it’s never too late to adopt a healthy lifestyle. For example, if you quit smoking now, your risk of heart disease begins to fall almost immediately.

Living a healthy lifestyle can improve how you age. Try the following:

  • Stop smoking.
  • Eat a healthy diet full of fruits, vegetables and whole grains.
  • Exercise for at least 30 minutes most days of the week.
  • Maintain a healthy weight.
  • Get enough sleep so that you wake feeling rested.
  • Follow your doctor’s guidance for checkups and health screenings.
Posted by A.F.Garcia,MD,CFP in 04:50:44 | Permalink | Comments (1) »

Friday, March 20, 2009

Study: Being obese can take years off your life

LONDON – Being obese can take years off your life and in some cases may be as dangerous as smoking, a new study says. British researchers at the University of Oxford analyzed 57 studies mostly in Europe and North America, following nearly one million people for an average of 10 to 15 years. During that time, about 100,000 of those people died.

The studies used Body Mass Index (BMI), a measurement that divides a person’s weight in kilograms by their height squared in meters to determine obesity. Researchers found that death rates were lowest in people who had a BMI of 23 to 24, on the high side of the normal range.

Health officials generally define overweight people as those with a BMI from 25 to 29, and obese people as those with a BMI above 30.

The study was published online Wednesday in the medical journal, Lancet. It was paid for by Britain’s Medical Research Council, the British Heart Foundation, Cancer Research UK and others.

“If you are heading towards obesity, it may be a good idea to lose weight,” said Sir Richard Peto, the study’s main statistician and a professor at Oxford University.

Peto and colleagues found that people who were moderately fat, with a BMI from 30 to 35, lost about three years of life. People who were morbidly fat — those with a BMI above 40 — lost about 10 years off their expected lifespan, similar to the effect of lifelong smoking.

Moderately obese people were 50 percent more likely to die prematurely than normal-weight people, said Gary Whitlock, the Oxford University epidemiologist who led the study.

He said that obese people were also two thirds more likely to die of a heart attack or stroke, and up to four times more likely to die of diabetes, kidney or liver problems. They were one sixth more likely to die of cancer.

“This really emphasizes the importance of weight gain,” said Dr. Arne Astrup, a professor of nutrition at the University of Copenhagen who was not linked to the Lancet study. “Even a small increase in your BMI is enough to increase your risks for cardiovascular disease and cancer.”

Previous studies have found that death rates increase both above and below a normal BMI score, and that people who are moderately overweight live longer than underweight or normal-weight people.

Other experts said that because the papers used in the study mostly started between 1975 and 1985, their conclusions were not as relevant today.

Astrup worried that rising obesity rates may reverse the steep drops in heart disease seen in the West.

“Obesity is the new dark horse for public health officials,” he said. “People need to be aware of the risks they’re taking when they gain weight.”

Posted by A.F.Garcia,MD,CFP in 08:35:00 | Permalink | Comments (1) »

Friday, February 27, 2009

Oral health: Brush up on dental care basics

Too tired to brush your teeth? Too busy to floss? If you’re tempted to skip these daily chores, remember that your smile depends on these simple dental care habits. Know how to promote oral health — and when to report oral health problems to your dentist.

Brushing for oral health

Oral health begins with clean teeth. Consider these brushing basics from the American Dental Association:

  • Brush your teeth at least twice a day. When you brush, don’t rush. Take enough time to do a thorough job.
  • Use the proper equipment. Use a fluoride toothpaste and a soft-bristled toothbrush. Consider using an electric or battery-operated toothbrush, especially if you have arthritis or other problems that make it difficult to brush effectively.
  • Practice good technique. Hold your toothbrush at a slight angle against your teeth and brush with short back-and-forth motions. Remember to brush the inside and chewing surfaces of your teeth, as well as your tongue. Avoid vigorous or harsh scrubbing, which can irritate your gums.
  • Know when to replace your toothbrush. Invest in a new toothbrush or a replacement head for your electric toothbrush every three to four months — or sooner if the bristles become frayed.

Flossing for oral health

You can’t reach the tight spaces between your teeth or under your gumline with a toothbrush. That’s why daily flossing is important. When you floss:

  • Don’t skimp. Break off about 18 inches of dental floss. Wind most of the floss around the middle finger on one hand, and the rest around the middle finger on the other hand — leaving about 1 inch to floss your first tooth.
  • Take it one tooth at a time. Use your thumbs and forefingers to gently pull the floss from the gumline to the top of the tooth to scrape off plaque. Rub the floss against all sides of the tooth. Unwind to fresh floss as you progress to the next tooth.
  • Keep it up. If you have trouble getting floss through your teeth, try the waxed variety. If it’s hard to manipulate the floss, use a floss holder or an interdental cleaner — such as a dental pick or stick designed to clean between the teeth.

Other oral health care tips

In addition to daily brushing and flossing, you might use an antimicrobial or antiseptic mouth rinse to help reduce plaque between your teeth.

To remove food particles from your teeth, you might try an oral irrigator — a device that aims a stream of water at your teeth. Resist the temptation to use toothpicks or other objects that could injure your gums. Keep in mind, however, an oral irrigator doesn’t replace daily brushing and flossing.

Oral health problems to report to your dentist

To prevent gum disease and other oral health problems, schedule regular dental cleanings and exams — generally at least once or twice a year. In the meantime, contact your dentist if you notice any signs or symptoms that may suggest oral health problems, such as:

  • Red, tender or swollen gums
  • Gums that bleed when you brush or floss
  • Gums that begin pulling away from your teeth
  • Loose teeth
  • Changes in the way your top and bottom teeth align with each other
  • Unusual sensitivity to hot and cold

Early detection and treatment of oral health problems can ensure a lifetime of good oral health.

Posted by A.F.Garcia,MD,CFP in 04:44:16 | Permalink | Comments (4)

Wednesday, January 14, 2009

Preventing colds may be as easy as vitamin ZZZ

CHICAGO – Fluff up the pillows and pull up the covers. Preventing the common cold may be as easy as getting more sleep. Researchers paid healthy adults $800 to have cold viruses sprayed up their noses, then wait five days in a hotel to see if they got sick. Habitual eight-hour sleepers were much less likely to get sick than those who slept less than seven hours or slept fitfully.

“The longer you sleep, the better off you are, the less susceptible you are to colds,” said lead author Sheldon Cohen, who studies the effects of stress on health at Pittsburgh’s Carnegie Mellon University.

Prior research has suggested that sleep boosts the immune system at the cell level. This is the first study to show small sleep disturbances increasing the risk of getting sick, said Dr. Michael Irwin, who researches immune response at the University of California, Los Angeles, and was not involved in the study.

“The message is to maintain regular sleep habits because those are really critical for health,” Irwin said.

During cold season, staying out of range of sneezing relatives and co-workers may be impossible. The study, appearing Monday in the Archives of Internal Medicine, mimicked those conditions by exposing participants to a common cold virus — rhinovirus — and most became infected with it.

But not everyone suffered cold symptoms.

The people who slept less than seven hours a night in the weeks before they were exposed to the virus were three times more likely to catch a cold than those who slept eight hours or more.

To find willing cold victims, researchers placed ads and recruited 78 men and 75 women, all healthy and willing to go one-on-one against the virus. They ranged in age from 21 to 55.

First, their sleep habits were recorded for two weeks. Every evening, researchers interviewed them by phone about their sleep the night before. Subjects were asked what time they went to bed, what time they got up, how much time they spent awake during the night and if they felt rested in the morning.

Then they checked into a hotel where the virus was squirted up their noses. After five days, the virus had done its work, infecting 135 of the 153 volunteers. But only 54 people got sick.

Researchers measured their runny noses by weighing their used tissues. They tested for congestion by squirting dye in the subjects’ noses to see how long it took to get to the back of their throats.

Sleeping fitfully also was tied to greater risk of catching a cold. Those who tossed and turned more than 8 percent of their time in bed were five times more likely to get sick than those who were sleepless only 2 percent of the time.

Surprisingly, feeling rested was not linked to staying well. Cohen said he’s not sure why that is, other than feeling rested is more subjective than recalling bedtime and wake-up time.

The researchers took into account other factors that make people more susceptible such as stress, smoking and drinking, and lack of exercise, and they still saw a connection between sleep and resisting a cold.

Cold symptoms like congestion and sore throat are caused by the body’s fight against a virus, rather than the virus itself, Cohen said. People whose bodies make the perfect amount of infection-fighting proteins called cytokines will not even know they are fighting a virus. But if their bodies make too many, they feel sick.

Sleep may fine-tune the body’s immune response, Cohen said, helping regulate the perfect response.

Prior research has tied lack of sleep to greater risk of weight gain, heart disease, high blood pressure, stroke and diabetes.

Dr. Daniel Buysse, a sleep researcher at the University of Pittsburgh, said spending too much time in bed can lead to more interrupted sleep, which in this study “seems to be even worse than short sleep” for increasing the risk of catching a cold.

If it takes a long time to fall asleep or if you are restless during the night, “you would probably benefit from spending a little LESS time in bed,” Buysse said in an e-mail. “If you fall asleep instantly, have no wakefulness during the night, and are sleepy during the day, you would probably benefit from spending a little MORE time in bed.”

Buysse was not directly involved in the research, although he commented on an early draft of the study. The study was funded by grants from the National Institutes of Health and the MacArthur Foundation.

Harvard sleep researcher Sat Bir Khalsa said people do not need to turn to prescription sleep aids to improve their sleep. Setting a regular bedtime, moving computers and televisions out of the bedroom and, when restless, getting out of bed for a while and doing something soothing can help. His research focuses on treating insomnia with yoga.

As preventive measures, vitamin C and herbal supplements have not lived up to their reputation in rigorous studies. Cohen said research has shown people who get more exercise, drink moderately and have lower stress also get fewer colds.

Posted by A.F.Garcia,MD,CFP in 02:04:15 | Permalink | Comments (4)

Tuesday, December 30, 2008

New Year Superstitions

Wear New Clothes
People believe that one should wear new clothes on a New Year’s Day. This would mean receiving more new garments during the year. Red clothing is preferred for New Year’s Day since red is considered a happy colour and is sure to attract for the wearer a brighter future.

Avoid Crying
It is said that one should avoid breaking things or crying and wailing on the first day of the year, if you don’t want to continue the pattern for the entire year.

Be Polite
People say that one should behave nicely on New Year and must refrain from using foul language. Ghost stories and conversations on death should also be avoided.

Lucky New Year Babies
Babies born on 1st January is said to be the luckiest of all throughout their lives.

Don’t Let Money Leave the House
In several countries, people do not let money, jewelry, precious items or other invaluable things leave home on New Year Day. Hence it is said that one should not pay loans and bills or lend things to anybody. People go to the extent of not taking out garbage or even not dusting their carpets on this day to ensure that nothing goes out of home during the year. If you have to deliver presents on New Year morning, it is advised to leave them in the car since New Year Eve on December 31st. In case you must take something out from the home, let someone come with the present inside the home first.

Letting the Old Year Out
At midnight, all the doors of a house must be opened to let the old year escape unimpeded.

Stack Up Cupboards and Wallets
It is believed that cupboards stocked up with food and wallets and purses full of money bring prosperity in New Year. Similarly, empty pockets or empty cupboards on New Years Eve portend a year of poverty.

Do not Wash Dishes
In several societies washing dishes and doing laundry on New Year’s day is said to lead to a death in the family during the year. Many people do not even wash hair on New Year day.

Do Token Amount of Work
It is said that one must do token amount of work on the New Year’s Day. This is said to ensure advancement in career. But starting out a serious work project is unlucky on New Year Day.

Make Noise
People believe that Evil One and his attendants and servants hate din and loud noise. So, scare them away by being as loud in New Year celebrations as possible. Church bells are rung at midnight for the same reason.

Don’t Keep Debts
Pay your bills and loans before New Year Eve, so you don’t have any debt left for New Year.

Eat Black-Eyes Peas
In Southern part of the United States it is said that eating of black-eyed peas on New Year’s Day will attract both general good luck and money in particular to the one doing the dining.

Kiss at Midnight
It is believed that kissing at midnight ensures that affections and ties will continue throughout the New Year. On similar lines, it is said, to not do this would be to set the stage for a year of coldness.

First Footing
One must never leave the home before someone comes in first. First footer in the house should be ushered in with a warm welcome and should not have flat feet, cross-eyes or eyebrows stretching out to meet in the middle. It would be even better if he came bearing certain small gifts.

The Direction of Wind
The direction of wind during sunrise on New Year morning prophesies about the coming year. Wind from south foretells fine weather and prosperous times ahead while wind from north foretells bad weather. Wind blowing from east foretells natural calamities and wind from west foretells plenty of milk and fish for all but death of a person of great national importance. No wind means joy and prosperity throughout the year.

Dance in the Open Air
To dance in the open air, especially round a tree, on New Year’s Day ensures luck in love and prosperity and freedom from ill health during the coming twelve months.

Find Future Groom
On New Year’s Day if, on rising, a girl should look out of her bedroom window and see a man passing by, she may reckon to be married before the year is finished.

Drain the Bottle
You could ensure yourself good fortune by draining the last dregs from a bottle of drink on New Years!

Posted by A.F.Garcia,MD,CFP in 08:34:41 | Permalink | Comments (3)

Tuesday, December 23, 2008

Give Love On Christmas Day!

Dear Ones,

YOU CAN GIVE WITHOUT LOVING

BUT YOU CAN NOT LOVE WITHOUT GIVING

SHARE LOVE THIS HOLIDAY SEASON!

HERE’S A GIFT FOR YOU MY FRIENDS…

 CLICK THE LINK BELOW FOR YOUR GIFT!

CLAIN IT NOW!

http://www.clements en.com/email/ friendship. php

HAVE A BLESSED CHRISTMAS!

Posted by A.F.Garcia,MD,CFP in 01:56:50 | Permalink | Comments (4)

Monday, December 15, 2008

G-Spot Guide

G-spot is the nickname for the Grafenberg spot, named after the guy who noted its erotic significance in the 1950′s. The G-spot in women is analogous to the prostate in men (which seems to play a more direct role in sex and procreation).

G-spot is the nickname for the Grafenberg spot, named after the guy who noted its erotic significance in the 1950′s. The G-spot in women is analogous to the prostate in men (which seems to play a more direct role in sex and procreation).

The G-spot is a gland located behind the pubic bone and around the urethra. It can be massaged or stimulated by reaching up about two finger joints distance on the upper surface of the vagina. If already aroused, some women will find that stimulation of this area leads to an intense orgasm which may be of a different quality from a clitoral orgasm. Stimulation of the spot produces a variety of initial feelings: discomfort, feeling the need to urinate, or a pleasurable feeling. With additional stroking the area may begin to swell and the sensations may become more pleasureable. Continuing stimulation may produce an intense orgasm. Like the prostate, the G-spot can produce an fluid like semen (but not as viscous) which may be released on orgasm- even known to “squirt” a couple of centimeters.

For comparison, the prostate in men is also located behind the pubic bone and around the urethra. The two ejaculatory ducts also end here (bringing sperm from the testis via vas deferens). The prostate can be reached through the anus (as in Doctors performing a prostate exam). Continued stimulation of the prostate may produce intense orgasms in men. The prostate is the glad which produces most of the seminal fluid that is ejaculated (other than the sperm in the semen).

For those who never had a close look at a vulva before and are a bit worried, I should say that, except when quite sincerely aroused, female genitals are usually clearly set out. The clitoris likes to hide under it’s own little hood, the lips stick pretty close to one another, and it is quite likely that if the owner of the genitals is standing up and unaroused you won’t really see more than some enticing tufts of hair and maybe the outer lips. People whose knowledge of these matters derives mainly from Playboy pictorials may be quite surprised that there’s more here than “just a hole”.

Traditionally it was thought that all of the sensation available from the female genitals derived from the lips, entrance to the vagina, and especially the clitoris. In other words, what you see above. It was thought that the interior of the vagina was practically numb to sexual sensation.

Now one of those old coots who spent his”professional” time sticking their noses into other people’s intimate businesses was a guy called Grafenberg. Dr. G. had this theory that there was an area within the vagina, which was called the Grafenberg spot or G-spot, which not only was sexually sensitive but which could trigger bigger and better female orgasms than the clitoris and the exterior bits could by themselves.

Now the trouble with Dr. G.’s claim was that not everyone seemed to be able to find this spot, which he reckoned was analogous with the male prostate gland, and those that did find it didn’t necessarily like it much, and so there was some controversy, especially in the popular press. A number of folks who did find it and did like it eventually soused out the mechanics of the spot, and in recent years there have been a number of good books about it.

The story is basically this: The G-spot is a flat area about as big as a nickel, about two inches inside the vagina. It’s just behind the pubic bone, on the vaginal wall that is closest to the belly button. You can reach it with your index finger. If the genitals you’re playing with are not very aroused then you might have difficulty finding it, or it might not feel very interesting or nice to the owner. The trick is to make those genitals very aroused, and then have a go at the G-spot. The best way is probably cunnilingus, which is Latin for having a lick, but any technique that provides good stimulation of the clitoris will do for starters.

Now bear in mind that I’m skipping over a lot here. I strongly recommend a good deal of foreplay before diving into a woman’s muff, like at least half an hour, and longer if you like. If you can manage dinner and a good bath beforehand, even better. Actually, I imagine that a bath or a shower before sex is a reasonably good idea anyway, because we’re dealing with equipment that can be quite undesirable if it’s on the nose when it’s on the nose, if you take my meaning. Besides, bathing together is fun, if that’s an option.

So, presuming that your woman is content with the preliminaries and you’re going hunting, you’re going to have to begin by relaxing. If you’re so messed up that slamming your dick in the door has a pleasurable side to it (sorry feminists, I’m not certain what the female equivalent to that state is) then forget all this until you’ve had a bloody good rogering or two.

Once you’ve achieved a state of patient interest, slowly start to stimulate the clitoris. You’ve got to be really careful here, because clitori are damned sensitive little beggars, and too much of a good thing is not really a good thing at all. Also, different clitori like different things. Some like very direct stimulation, some prefer one side or the other, others are so sensitive that they like you to mainly stick to the clitoral hood or the labia. Some like a circular motion, and others like to be lightly flicked back and forth. The best way to find out what your clitoris likes is to ask it’s owner, and if she doesn’t know then do some experimentation. That’s fun too, so don’t get pissed off if it takes a little while to figure out what’s good for you.

As I said, my preferred method is cunnilingus, but if the owner of your clitoris doesn’t like that for some reason (“no, my dear, it’s not germy and it does taste rather nice”) then you’ll have to use your fingers. I find that the best thing for clitori is a nice regular stroke, with regular exotic interludes. Basically it’s the same thing as for penises – you don’t want all sorts of unpredictable jerking around, and you don’t want to feel like it’s caught in a vise, and you don’t want it to feel like it’s attached to a reciprocating engine going at 5000 revs. Take it easy. If the owner of your clitoris wants more stimulation you’ll notice her writhing around and pushing it at you. If she wants less then she’ll draw away. If it’s just right then she’ll sit where she is and enjoy it. Pay attention to what she does. When it comes to pleasuring a woman, she says a lot more with her actions than with her words.

So, you’ve got a nice regular stroke going – say, seven strokes and then something exotic, and then another seven strokes and another something exotic. Of course the G spot is in the vagina, and you’re going to have to know what’s going on in there if you’re going to find it and do something with it. Slowly insert a finger or two. Don’t grab, because that can be rude and distracting.

Now hopefully the vagina that you’re dealing with is well lubricated, but that won’t necessarily be the case. If you spend a long time at this even the juiciest woman can start to dry out, so it never hurts to have a little lubricant handy, just in case. I’d recommend K-Y jelly, which you should be able to find at any pharmacy, but there are lots of alternatives. One that I wouldn’t recommend is Vaseline – too thick. Another is baby oil, it’s too thin.

You can entertain yourself by running your finger around the inside of the vagina, trying to discern its shape. Unless your female is coming (having an orgasm), you should probably find that the vagina is reasonably form-fitting, although some are tighter than others. If your female is not coming or consciously causing contractions you’ll probably find that the vagina isn’t doing anything in particular, just sitting there and producing lubricant. If you bring your finger to the front wall of the vagina then you’ll find it less yielding than the rest, because there is a bone in front of it called the pubic bone, part of the pelvis. If you feel along this unyielding section or just beyond you may find a slightly raised area. This is the G spot. It might not be raised, but it will engorge once your female starts to come.

Don’t poke this spot yet. Don’t do anything with it, yet. At best you won’t have any effect, and at worst you’ll be distracting. You’ve got to wait for your female to start to come. Now this might happen in thirty seconds, or it might take an hour, and you’ve just got to be patient and keep things regular and smooth. You’ll be able to tell your woman is coming when:

she tells you: she moans one hell of a lot and her breathing changes
she flushes: over her face, neck and/or chest
her vagina begins to flutter rhythmically around your finger

You may see all of these things, or you may see none of them. If you miss an orgasm, don’t stop unless you or she wants to. Women have startling recuperative powers, particularly when they’re receiving the right level of attention, and generosity is its own reward. Multiple orgasms are not mythical.

Once you believe that your woman is coming you should shift your attention from the clitoris to the G spot. Keep up the same rhythm, but use more pressure. You may want to keep some sort of contact with the clitoris, but just as a penis becomes super-sensitive during orgasm, to the point of discomfort, so can a clit.

As with the clitoris, you should pay attention to whether the woman pushes towards you, draws away from you or just sits there to gauge the amount of pressure you’re giving. You probably won’t need to vary your speed much, but pay attention to what she says she wants.

Now as you go at the G-spot you’ll find that your woman keeps coming for longer than you’ve seen before. You may even experience that most startling of sexual phenomena, a female ejaculation. I’ve seen three of these (actually I got a mouthful), but I can’t say whether the fluid comes from the vagina or the urethra. It’s quite nice, sort of like salad dressing. It’s definitely not urine, and it is probably polite and hopefully reciprocal to swallow it.

Keep going at that G-spot. Eventually you will feel the vagina draw away from your finger – it becomes bigger and the walls get taut, and not form-fitting, sort of like a little cave. When it does this it’s time to switch back to the clitoris. Keep up the same rhythm. When the vagina begins to contract on your finger again, go back to the G-spot.

If you keep this up for a while (and if the owner of your female genitals wants to stop, then stop – this isn’t a competition), you’ll find that the nature of the vaginal contractions changes. The cave effect becomes less and less frequent and you can spend more and more time with the G-spot. Also, the contractions in the vagina become less simple squeezing and fluttering, and more a sort of reverse swallowing – a contraction that starts deep within the vagina and travels to its entrance. It feels a bit like the vagina is trying to push your finger out. Eventually (may take hours and patience and many tries) you’ve got nothing but these push-out contractions, and you can go on as long as the owner of the genitals wants to, and your tongue and fingers don’t wear out. If you go on this long you’re almost certainly going to need some extra lubricant, so be prepared.

There you have it. At least in my experience, women can have orgasms that last orders of magnitude longer and seem to be much better than those that men can have. I guess I better add a disclaimer that all of this is only one man’s experience, and I could be completely wrong about the female genitals that you have. I’m not certain there is such a thing as device independence where sexual equipment is concerned. I don’t think that any of the things I’ve advocated can do you any harm, but see your doctor if you’ve got doubts. The main thing is to have fun. e G-spot is a gland located behind the pubic bone and around the urethra. It can be massaged or stimulated by reaching up about two finger joints distance on the upper surface of the vagina. If already aroused, some women will find that stimulation of this area leads to an intense orgasm which may be of a different quality from a clitoral orgasm. Stimulation of the spot produces a variety of initial feelings: discomfort, feeling the need to urinate, or a pleasurable feeling. With additional stroking the area may begin to swell and the sensations may become more pleasureable. Continuing stimulation may produce an intense orgasm. Like the prostate, the G-spot can produce an fluid like semen (but not as viscous) which may be released on orgasm- even known to “squirt” a couple of centimeters.

For comparison, the prostate in men is also located behind the pubic bone and around the urethra. The two ejaculatory ducts also end here (bringing sperm from the testis via vas deferens). The prostate can be reached through the anus (as in Doctors performing a prostate exam). Continued stimulation of the prostate may produce intense orgasms in men. The prostate is the glad which produces most of the seminal fluid that is ejaculated (other than the sperm in the semen).

For those who never had a close look at a vulva before and are a bit worried, I should say that, except when quite sincerely aroused, female genitals are usually clearly set out. The clitoris likes to hide under it’s own little hood, the lips stick pretty close to one another, and it is quite likely that if the owner of the genitals is standing up and unaroused you won’t really see more than some enticing tufts of hair and maybe the outer lips. People whose knowledge of these matters derives mainly from Playboy pictorials may be quite surprised that there’s more here than “just a hole”.

Traditionally it was thought that all of the sensation available from the female genitals derived from the lips, entrance to the vagina, and especially the clitoris. In other words, what you see above. It was thought that the interior of the vagina was practically numb to sexual sensation.

Now one of those old coots who spent his”professional” time sticking their noses into other people’s intimate businesses was a guy called Grafenberg. Dr. G. had this theory that there was an area within the vagina, which was called the Grafenberg spot or G-spot, which not only was sexually sensitive but which could trigger bigger and better female orgasms than the clitoris and the exterior bits could by themselves.

Now the trouble with Dr. G.’s claim was that not everyone seemed to be able to find this spot, which he reckoned was analogous with the male prostate gland, and those that did find it didn’t necessarily like it much, and so there was some controversy, especially in the popular press. A number of folks who did find it and did like it eventually soused out the mechanics of the spot, and in recent years there have been a number of good books about it.

The story is basically this: The G-spot is a flat area about as big as a nickel, about two inches inside the vagina. It’s just behind the pubic bone, on the vaginal wall that is closest to the belly button. You can reach it with your index finger. If the genitals you’re playing with are not very aroused then you might have difficulty finding it, or it might not feel very interesting or nice to the owner. The trick is to make those genitals very aroused, and then have a go at the G-spot. The best way is probably cunnilingus, which is Latin for having a lick, but any technique that provides good stimulation of the clitoris will do for starters.

Now bear in mind that I’m skipping over a lot here. I strongly recommend a good deal of foreplay before diving into a woman’s muff, like at least half an hour, and longer if you like. If you can manage dinner and a good bath beforehand, even better. Actually, I imagine that a bath or a shower before sex is a reasonably good idea anyway, because we’re dealing with equipment that can be quite undesirable if it’s on the nose when it’s on the nose, if you take my meaning. Besides, bathing together is fun, if that’s an option.

So, presuming that your woman is content with the preliminaries and you’re going hunting, you’re going to have to begin by relaxing. If you’re so messed up that slamming your dick in the door has a pleasurable side to it (sorry feminists, I’m not certain what the female equivalent to that state is) then forget all this until you’ve had a bloody good rogering or two.

Once you’ve achieved a state of patient interest, slowly start to stimulate the clitoris. You’ve got to be really careful here, because clitori are damned sensitive little beggars, and too much of a good thing is not really a good thing at all. Also, different clitori like different things. Some like very direct stimulation, some prefer one side or the other, others are so sensitive that they like you to mainly stick to the clitoral hood or the labia. Some like a circular motion, and others like to be lightly flicked back and forth. The best way to find out what your clitoris likes is to ask it’s owner, and if she doesn’t know then do some experimentation. That’s fun too, so don’t get pissed off if it takes a little while to figure out what’s good for you.

As I said, my preferred method is cunnilingus, but if the owner of your clitoris doesn’t like that for some reason (“no, my dear, it’s not germy and it does taste rather nice”) then you’ll have to use your fingers. I find that the best thing for clitori is a nice regular stroke, with regular exotic interludes. Basically it’s the same thing as for penises – you don’t want all sorts of unpredictable jerking around, and you don’t want to feel like it’s caught in a vise, and you don’t want it to feel like it’s attached to a reciprocating engine going at 5000 revs. Take it easy. If the owner of your clitoris wants more stimulation you’ll notice her writhing around and pushing it at you. If she wants less then she’ll draw away. If it’s just right then she’ll sit where she is and enjoy it. Pay attention to what she does. When it comes to pleasuring a woman, she says a lot more with her actions than with her words.

So, you’ve got a nice regular stroke going – say, seven strokes and then something exotic, and then another seven strokes and another something exotic. Of course the G spot is in the vagina, and you’re going to have to know what’s going on in there if you’re going to find it and do something with it. Slowly insert a finger or two. Don’t grab, because that can be rude and distracting.

Now hopefully the vagina that you’re dealing with is well lubricated, but that won’t necessarily be the case. If you spend a long time at this even the juiciest woman can start to dry out, so it never hurts to have a little lubricant handy, just in case. I’d recommend K-Y jelly, which you should be able to find at any pharmacy, but there are lots of alternatives. One that I wouldn’t recommend is Vaseline – too thick. Another is baby oil, it’s too thin.

You can entertain yourself by running your finger around the inside of the vagina, trying to discern its shape. Unless your female is coming (having an orgasm), you should probably find that the vagina is reasonably form-fitting, although some are tighter than others. If your female is not coming or consciously causing contractions you’ll probably find that the vagina isn’t doing anything in particular, just sitting there and producing lubricant. If you bring your finger to the front wall of the vagina then you’ll find it less yielding than the rest, because there is a bone in front of it called the pubic bone, part of the pelvis. If you feel along this unyielding section or just beyond you may find a slightly raised area. This is the G spot. It might not be raised, but it will engorge once your female starts to come.

Don’t poke this spot yet. Don’t do anything with it, yet. At best you won’t have any effect, and at worst you’ll be distracting. You’ve got to wait for your female to start to come. Now this might happen in thirty seconds, or it might take an hour, and you’ve just got to be patient and keep things regular and smooth. You’ll be able to tell your woman is coming when:

she tells you: she moans one hell of a lot and her breathing changes
she flushes: over her face, neck and/or chest
her vagina begins to flutter rhythmically around your finger

You may see all of these things, or you may see none of them. If you miss an orgasm, don’t stop unless you or she wants to. Women have startling recuperative powers, particularly when they’re receiving the right level of attention, and generosity is its own reward. Multiple orgasms are not mythical.

Once you believe that your woman is coming you should shift your attention from the clitoris to the G spot. Keep up the same rhythm, but use more pressure. You may want to keep some sort of contact with the clitoris, but just as a penis becomes super-sensitive during orgasm, to the point of discomfort, so can a clit.

As with the clitoris, you should pay attention to whether the woman pushes towards you, draws away from you or just sits there to gauge the amount of pressure you’re giving. You probably won’t need to vary your speed much, but pay attention to what she says she wants.

Now as you go at the G-spot you’ll find that your woman keeps coming for longer than you’ve seen before. You may even experience that most startling of sexual phenomena, a female ejaculation. I’ve seen three of these (actually I got a mouthful), but I can’t say whether the fluid comes from the vagina or the urethra. It’s quite nice, sort of like salad dressing. It’s definitely not urine, and it is probably polite and hopefully reciprocal to swallow it.

Keep going at that G-spot. Eventually you will feel the vagina draw away from your finger – it becomes bigger and the walls get taut, and not form-fitting, sort of like a little cave. When it does this it’s time to switch back to the clitoris. Keep up the same rhythm. When the vagina begins to contract on your finger again, go back to the G-spot.

If you keep this up for a while (and if the owner of your female genitals wants to stop, then stop – this isn’t a competition), you’ll find that the nature of the vaginal contractions changes. The cave effect becomes less and less frequent and you can spend more and more time with the G-spot. Also, the contractions in the vagina become less simple squeezing and fluttering, and more a sort of reverse swallowing – a contraction that starts deep within the vagina and travels to its entrance. It feels a bit like the vagina is trying to push your finger out. Eventually (may take hours and patience and many tries) you’ve got nothing but these push-out contractions, and you can go on as long as the owner of the genitals wants to, and your tongue and fingers don’t wear out. If you go on this long you’re almost certainly going to need some extra lubricant, so be prepared.

There you have it. At least in my experience, women can have orgasms that last orders of magnitude longer and seem to be much better than those that men can have. I guess I better add a disclaimer that all of this is only one man’s experience, and I could be completely wrong about the female genitals that you have. I’m not certain there is such a thing as device independence where sexual equipment is concerned. I don’t think that any of the things I’ve advocated can do you any harm, but see your doctor if you’ve got doubts. The main thing is to have fun.

Posted by A.F.Garcia,MD,CFP in 09:13:54 | Permalink | Comments (5)