Dog Zen

It's almost Monday morning, time for an adorable Rule of Dog treat.

"I cheated. This is my punishment."


Our venerable media outlets inform us that there's a guy sitting at an intersection, somewhere, carrying a "I cheated. This is my punishment." sign. And the likelihood that the protagonists of this most important piece of news are doing a promo for an upcoming movie? I'd say 99.9 % (my guess, this one).

i-Pill / Nextime Emergency Contraceptive Pill

SECOND UPDATE Nov. 2011: Back to i-Pill on Amazon, with Nextime now out-of-stock. The i-Pill and Nextime links now go to their respective Amazon pages. Just see which one is available and buy it, they're the same ECP.

UPDATE: The i-Pill's brand name has been changed to Nextime. I've changed the post to reflect that.

Leave it to Amazon to alert us to the availability of the i-Pill / Nextime emergency contraceptive pill. What is the i-Pill / Nextime?

You already know what Plan B and Plan B One-Step are. The i-Pill / Nextime is the same as Plan B One-Step and, since we're on the subject, the same as Levonelle One Step/Levonelle 1500 (different manufacturers, of course).

Plan B -- 2 pills (0.75 mg levonorgestrel/pill); take both pills at the same time as soon as possible after unprotected intercourse, up to 120 hours (5 days).

i-Pill/Nextime/Plan B One-Step -- 1 pill (1.5 mg levonorgestrel); take the pill as soon as possible after unprotected intercourse, up to 120 hours (5 days).

  • The i-Pill / Nextime, like Plan B One-Step, is an emergency contraceptive pill. You take it to prevent pregnancy *after* an act of unprotected sexual intercourse. The sooner you take it the more effective it is (up to 89% reduction in pregnancy risk).

  • The i-Pill / Nextime doesn't work if you're already pregnant. It will not terminate a pregnancy.

  • Because the i-Pill / Nextime contains only a progestin (levonorgestrel) you can take it even if you can't use regular birth control pills.

  • The most common side effects are nausea, vomiting, breast tenderness--should resolve in a day or two--and menstrual changes. Most likely you'll have a normal period within the next month, but sometimes the next period can come as much as a week earlier or a week later than usual.

  • Last, but not least, don't use the i-Pill / Nextime as regular birth control. Once you've resolved the emergency, select a birth control method that meets your needs and use it correctly and consistently.

Bottom line: If you are a sexually active woman or man of reproductive age and you're not planning a pregnancy you need to have the emergency contraceptive pill handy.

So go check out the i-Pill Emergency Contraceptive Pill / Nextime Emergency Contraceptive Pill at Amazon where it's on sale for a [surprisingly] reasonable $19.98.

N.B. Other than the Amazon link, I have no financial interest in/ties with any of the ECP manufacturers.

Dog Zen

It's Monday Morning, adorable sleeping puppy time over at Rule of Dog.

Dog Zen

It's almost Monday morning, time for puppy cuteness at Rule of Dog.

God’s Stimulus Package

Michael Stravato for The New York Times

Any time a worried thought about money pops up in your mind the next thing you do is send me some money and, um, a motorcycle.

And speaking of religion, how low can Yale University Press go?

Update on Menstrual Cups: Instead, DivaCup, Keeper, Sea Sponge Tampons and Gynotex

Just to let you know, I updated the Menstrual Cups post with a very good pic of the Sea Sponge Tampon I found on Amazon:

As you can see, there are slight shape and size variations between the individual sponges; that's perfectly normal.

The two most frequent questions I'm asked about sponge use are:

1) How does it feel to use a sea sponge tampon?

Obviously, each person is different, but, as a general rule, if you insert it correctly--same motion used for inserting a tampon; push sponge all the way in, high up close to the cervix--you shouldn't be able to feel it.

Some women report a foreign body sensation after insertion (of either a tampon or a sea sponge). The most likely problem: the sponge sits too low in the vaginal canal.

To correct this, keep in mind that you have to insert the sponge along the vaginal axis. The axis is neither parallel nor perpendicular to the floor. This means you don't push the sponge straight in or straight up, in one motion. Rather, you use a two-step motion: start the insertion with fingers about parallel to the floor, continue and end the insertion with fingers in an upward direction. Something like this [please disregard the quality of my "art"; a bit crude but it does the job]:

2) Can I have sex with the sea sponge tampon in place?

Sure you can, the question is should you? As long as you're aware that the sponge tampon is not a birth control method and will not protect you against pregnancy (or STIs for that matter), the decision is up to you. Again, as a general rule, your partner will most likely not experience any discomfort from the sponge.

As always, keep in mind that this is just a brief blog post on using a sea sponge as a menstrual tampon. For a full discussion of the pros and cons talk to your own Ob/Gyn.

Esquire's John H. Richardson Bumbles "The Last Abortion Doctor" Story

Is it possible that Esquire's John H. Richardson was a tad high when he cobbled together "The Last Abortion Doctor"? Read Mr. Richardson's embarrassing attempt at a profile piece on Dr. Warren Hern, a Boulder, Colorado Ob/Gyn, and judge for yourselves.

For example, take this rather elephantine factual inaccuracy in "The Last Abortion Doctor":

For thirty-six years, Warren Hern has been one of the few doctors in America to specialize in late abortions. George Tiller was another. And when Dr. Tiller was murdered that Sunday in church, Warren Hern became the only one left.

Granted, Dr. LeRoy Carhart is on a death watch and the U.S. Department of Justice has just removed his protection detail but let's wait until he's actually assassinated before we pretend he doesn't even exist. Especially in light of the fact that Dr. Carhart plans to open a clinic in, you know, Kansas.

And what about the Ob/Gyns attached to hospital clinics? They certainly aren't as high profile as Drs. Tiller, Carhart, and Hern but they do exist.

It's unprofessional for a reporter to get facts wrong under the best of circumstances. In light of the current open season on Ob/Gyn and their patients it's irresponsible to mislead readers about the availability of needed medical care.

Moving on, John H. Richardson throws a bizarre temper tantrum. Like an aggrieved 2 yo Mr. Richardson figuratively holds his breath and refuses to refer to Dr. Hern, and only Dr. Hern, as "doctor" because:

By the way, he hates the word abortionist. Though it is a simple descriptive term like "podiatrist".... All the same, it is the right word, an accurate word, and our discomfort with it is but a measure of how poisoned the language of abortion has become.

Throughout the article John H. Richardson calls Dr. Hern the "abortionist" 28 times, and giddily, even in his oxygen-deprived state, refers to Dr. Hern's family as [t]he abortionist's mother, [t]he abortionist's wife.

Mind you, don't take my word for how many times "abortionist" appears in the piece. Feel free to doublecheck as I, a deliveryist, was in a bit of a rush when I did the math on account of having to catch a ride with a bladder suspensionist to see our friend, the root canalist.

Next, we have:

But let's face it, abortion is the lowest-status activity in medicine. That's why they always call their clinics Family Planning Centers or Women's Wellness Facilities or some crap like that. Not his place. It's had the same name since 1975. Because I felt that performing abortions was the most important thing I could do in medicine.


The abortionist is very caring with all [his staff], she says. Like all doctors, he wants things done exactly his way. But he doesn't tolerate them being treated poorly. He pays them well. He gives them insurance and 401(k)'s, which is not routine in the abortion trade.

Well, duh! Not only is providing specialized, much needed and appreciated, safe, effective medical care to, you know, that lowliest, most disgusting, pariah of patients, the pregnant female, the lowest status activity in the whole of medicine and a filthy trade, but the pregnant uterus isn't even part of the reproductive tract and plays no role in a woman's reproductive function or her health status.

Last, but not least, what's with the "It rubs the lotion on its skin, or else it gets the hose again" vibe? When your job is to convey information and you're not very good at it, the last thing you should do is to employ a pretentious reporting style. Unless, of course, your goal is to have the image of John H. Richardson twirling around in a silk cape gently interrogating poor post-op patients in the recovery room, making little old ladies cry, and shouting "abortionist" at random intervals embedded in your poor readers' heads.

Bottom line: It's a shame Esquire couldn't find a professional reporter to tell the story of Dr. Warren Hern.

ETA: Via righteousrevolution, here is what a professional profile piece on an Ob/Gyn, Dr. LeRoy Carhart in this case, looks like.

Dog Zen

A double dose of cute this Monday morning from Rule of Dog.

Dr. Leroy Carhart Death Watch

I'm disgusted and I'm saddened, and I hate it that [Dr. LeRoy Carhart]'s here in Nebraska and I hate it that he's in America. I mean, this guy is one sick individual.

Dr. LeRoy Carhart, a Nebraska Ob/Gyn who covered Dr. Tiller at his Wichita clinic before it closed following Dr. Tiller's assassination on May 31, plans to open a reproductive health clinic in Kansas that will provide therapeutic late-term abortions.

The obligation to provide patients with proper medical care and to care for them comes with the territory and is nothing remarkable. Thousands of Ob/Gyns do it day in and day out all over the country.

Dr. Carhart's commitment to provide care to patients and to stand by them in the face of domestic terrorism and a high likelihood that he'll be assassinated is extraordinary and humbling.

Arizona Governor Jan Brewer and the Obama Administration Endanger Public Health

What is one thing you can do if your goal is to worsen the health of Arizona women, increase health-care costs, and endanger public health?

If you're Arizona Governor Jan Brewer you can apply for more than $1 million in federal grant funding for abstinence-only education in schools and be very pleased when the funding is granted.

If you're the Obama administration you can, you know, make funds available for abstinence-only "education", the withholding of complete and correct medical information from young people.

Billy Mays' Medical Information


Like many of you I was surprised by the news that cocaine use had contributed to the heart disease that suddenly killed popular TV pitchman Billy Mays. But what really blew me over was the conduct of the Hillsborough County medical examiner's office:

The medical examiner "concluded that cocaine use caused or contributed to the development of his heart disease, and thereby contributed to his death," the office said in a press release.


Mays' family questioned the finding of cocaine and criticized the medical examiner's officer for issuing the report.

Releasing details of a patient's medical history via press release, and no next-of-kin authorization. Can you get any more professional than the staff of the Hillsborough County medical examiner's office?

Plan B One-Step and Next Choice

The FDA has approved Plan B® One-Step, a new one-pill formulation of the emergency contraceptive Plan B.

Plan B® One-Step is one progestin-only pill (1.5 mg levonorgestrel) you take as soon as possible after unprotected intercourse (most effective within the first 24 hours). The i-Pill is another one progestin-pill emergency contraceptive pill brand, from a different manufacturer.

And speaking of new FDA approvals, the FDA also approved Next Choice™, a generic version of the original two-pill Plan B® formulation.

All clear? Let's review:

Plan B -- 2 pills (0.75 mg levonorgestrel/pill); take both pills at the same time as soon as possible after unprotected intercourse, up to 120 hours. **Plan B had been discontinued.**

Next Choice™ [Plan B generic version] -- 2 pills (0.75 mg levonorgestrel/pill); take both pills at the same time as soon as possible after unprotected intercourse, up to 120 hours.

Plan B® One-Step/i-Pill -- 1 pill (1.5 mg levonorgestrel); take the pill as soon as possible after unprotected intercourse, up to 120 hours.

Oh, and in case you forgot:

Although ACOG is encouraged by recent FDA actions, it reiterates its long-held position that there is no valid scientific or medical reason to impose an age restriction on the availability of EC because it is safe and effective for adolescents and women of all ages. ACOG again urges the FDA to withdraw the age restriction altogether and eliminate the behind-the-counter status for EC.

Check out the i-Pill Emergency Contraceptive Pill at Amazon where it's on sale for only $19.98.

ETA: I've added the information about the i-Pill to the original post.

Dog Zen

It's Monday morning, time to allow another Rule of Dog sleepyhead puppy to put a smile on your face.

Real Estate Sport

The 4 bedrooms, 4.5 baths New York City apartment looks quite unappealing, but the private year-round pool and wrap terrace are totally worth the $9,950,000 million price tag: