Orthorexia Nervosa

Posted: 8 days ago in Health Lifestyle Wellness


Just when you thought it was safe to go back in the kitchen…

As long there have been “modern” foods (fast, processed, junk, etc.) available, there have been issues surrounding food.  Overeating, binging, anorexia, purging, guilt, deprivation – it’s an epidemic that effects an estimated 8 million Americans (who are mostly women). Hence the reason why February 22-28 is National Eating Disorder Awareness week.

NEDAAs a health care provider I have pushed, cajoled and encouraged my patients – okay, and my family – to adopt healthier eating habits, and I know many of my colleagues in the health care professions have done the same.

Perhaps we’ve gone too far with some of you? There is an emerging trend of a new breed of eating disorder called “Orthorexia Nervosa”.

What the heck is that???”, you say?

Well, if you are feeling a bit neurotic about eating ONLY healthy foods, or find yourself becoming super-picky about where your food comes from or how it’s prepared, or even find that obsessing about food starts to nudge out other things in your life, you may be exhibiting signs of orthorexia nervosa.

Houston, we have a problem.  

In my not-so-humble opinion, it’s a far lesser problem than the food issues on the opposite end of the spectrum.  Eating McDonald’s every day or being anorexic can kill you; eating only pastured beef and organic veggies will not – but if you are obsessing about what you put in your mouth, you (or your friends and family!) may begin to wish you were dead.

Most of us can benefit from a little more ‘healthy’ in our diet, but if you find yourself having some of these behaviors, it may be time to regroup, and get some help if necessary:

  • Planning your entire day around your food intake
  • Feeling like a failure if you eat something that you deem unhealthy
  • Refusing to eat something if you don’t know where the ingredients come from
  • Judging others for their food choices
  • Eating well for the sense of control it gives you, instead of to nourish your body and satisfy hunger

But, and this is a BIG but – must we make a mountain out of every molehill?  Why must every behavior be diagnosable? Can’t we just be quirky?  Quirky, schmirky.  Of course, any behavior that interferes greatly with living life should be addressed. The rest of you? Just please, take a chill pill.  Life is all about a healthy balance.

And if you find that it’s harder than just a simple decision (I in no way want to discount your struggle) please seek professional help. NEDA, The National Eating Disorders Awareness organization can provide you just that.

Love ya lots,

6 Pregnancy Perks That Make It All Worth It

Posted: 15 days ago in Pregnancy


Weight gain.  Stretch marks.  Nausea. 

What’s in this pregnancy thing for me? (Besides a bundle of joy after an endless 10 months, that is?)

Actually, there are a few little secret scoobies, a.k.a. pregnancy perks to look forward to. And they are…

  1. Your body increases blood flow to all of your mucous membranes (read:  pink parts!)  in preparation for birth.  What does that mean to you?  Well, if you keep up with the Kardashian’s at all, you know that all of them pay a pretty penny to plump their puckers.  You, my dears, will get the prettiest pouts EVER, just by being pregnant!  It’s true!
  2. Guess what other pink part benefits?  Your vajayjay.  Increased blood flow means increased arousal + lubrication = more enjoyable sex.  Yeah, yeah, I know that ‘the bump’ can preclude feeling sexy.  To avoid this, just dim the lights; but between those lips and those lips, hubba hubba – it’s smokin’ hot in preggo town!
  3. And did I mention the visit from the booby fairy?  In preparation for breastfeeding, the milk factory is working overtime to nourish your baby.  Until s/he arrives, let your new curves work for you – show a little cleavage, buy a sexy bra – no padding needed!
  4. What about the pregnancy glow?  You’ve seen it, haven’t you?  Once the puking stops (and for the great majority of us, it will!), the green pallor can turn a luminous peachy glow seemingly overnight, as a result of hormones and great prenatal vitamins.  This also contributes to shiny hair and strong nails.  And with great skin, hair, and nails — a girl doesn’t need much else!
  5. More kindness and courtesy than you can stand to handle!  It’s a proven fact that society typically caters to pregnant women.  You’ll get a seat when there isn’t one, more doors held for you, and maybe even some freebies.  I say live it up while you can, because it really is short-lived.
  6. One word.. Babymoon.  Book it and enjoy. (This one only holds true for baby #1, sowwy!)

See what you have to look forward to? 

Instead of moaning and groaning about the downsides of pregnancy, focus on the many upsides. You did choose this, right?  No one is pregnant forever, and trust me, you will have many bigger fish to fry once the baby comes.


Love is in the Details

Posted: 20 days ago in Sex & Relationships


My hottie husband treats me really, really well every day.

That’s not a brag, either. We all deserve to have partners who love us and treat us like we are the cat’s meow, don’t we?

So why do I feel just a little bit bitchy if we don’t “do” the Valentine’s Day thing? I mean, I’ll take 365 days of an amazing husband over one day of flowers and candy any time. And I don’t really want to go to an overcrowded restaurant on amateur night, nor do I want him to spend $75 bucks on a $25 bouquet of flowers.

I guess I’m just as vulnerable as the next girl to the media’s expectation of romance. But I don’t want to be.

In fact, last year, I splurged on a couple’s massage for the two of us, envisioning a mid-week rendezvous while the girls were home doing schoolwork. 

In reality… We rushed out the door into a cold, rainy night. The massage was a bit awkward, as our therapists communicated by whispering in our ears so as not to disturb our partners. So exhausted from our long days, we both fell asleep on our massage table. To top it off, instead of a post-massage glass of wine and make-out session, we wiped the drool from our sheet-creased faces and stumbled home in a stupor. All in all, it was really a creepy, somewhat un-fulfilling experience.


True romance isn’t reserved for one cold day in mid-February. True romance is making a smoothie for your partner every single morning without complaint, even if you don’t really want to. Or, cleaning the kitchen every single night after Hurricane Tania obliterates it (yet again). And even staying up late to help your honey prepare for an early morning meeting.

loveisinthedetails-textMaybe this year I’ll give Hallmark the metaphorical finger and delight in the fact that I get to wake up next to my forever-boyfriend every morning, with or without the obligatory card and candy. 

What do you think?

Childbirth Education Series: The Use of Pitocin to Induce Labor

Posted: 21 days ago in Pregnancy

Prolapse: The ‘Fall’ of Womanhood

Posted: 24 days ago in Everything Else Health Wellness


(Your vagina, that is!)

Puberty. Pregnancy. Peeing your pants. Perimenopause. Just when you thought it was safe to go back in the bathroom, your body has another little “P” surprise for you:

Prolapse. In other words, are your insides hanging outside?

Whaaaaaat? Yes, you heard me correctly – sometimes, our insides fall out. Things like pregnancy and straining can weaken the muscles and ligaments of our pelvic floor, to the point where those tissues that are designed to hold our girl parts in become compromised. Gravity, age, and the loss of estrogen contribute as well, which means that if you have a uterus, you are at risk of all hell breaking loose.

A.k.a., Uterine prolapse. Sorry, ladies.

A mild prolapse – when the uterus bulges into the vagina just a bit – probably won’t cause you any grief, nor require any treatment. However, more significant cases will let you know that something just ain’t right. Suffice it to say, if you see or feel something bulging out of your vagina, you should get that checked ASAP. Frankly, why anyone wouldn’t leaves me scratching my head.

Other signs your insides may be creeping toward the light:

  • Chronic constipation
  • Urine leakage or retention
  • A heavy or pulling feeling in your vagina
  • Chronic, dull low back pain
  • A loss of tone or sexual sensation

If your doctor diagnoses a significant prolapse, s/he may prescribe:

  1. A pessary to try to hold things in. This looks like a diaphragm, and can do a decent job but may irritate surrounding tissues. There are surgical procedures to correct prolapse as well, but as with all surgery, it comes with risks and side effects, so this should only be considered in the most severe cases.
  2. Kegel exercises. These can be quite effective at preventing and managing prolapse  (as if you needed yet another reason to do them!). I am doing them right now as I write this, and not even the repairman or the dog at my feet are privy to my calisthenics. Need some guidance on how-to? Check this out.
  3. Maintain a healthy weight via a diet that supports regular bowel movements. Simply put, more weight in your belly = more internal pressure on those delicate organs. Plus, a healthy diet full of fiber will reduce constipation, which in turn reduces straining. And that brings us to…
  4. Reduce straining when at all possible! A little tip for when you are lifting/coughing/pooing – exhale with every exertion, and DO NOT hold your breath! This will keep the stress in your muscles and out of your hoo-ha.

Uterine prolapse won’t kill you, but it will put a serious damper in your love life, and your day-to-day routines. If you follow the above recommendations and high-tail it to your doc at the first sign of a problem, you can manage this little gift of woman-hood without too much stress.

My Lactation Consultant Felt Me Up

Posted: 27 days ago in Parenting


If you maintained any sense of modesty during prenatal care and childbirth, good for you.

The fun, however, is not over.

If you are one of the many who don’t take to nursing your baby with ease, you will probably end up having a date meeting with a lactation consultant. I am a huge fan of anyone who can help Mamas nurse their babies, so thank Goddess for these helpers. But – they will feel you up like you’ve never been felt up before, so be ready.

I mean, there you are, all laid up in the hospital or birthing center with a new little baby. Your mission is to get that baby to latch on correctly in order to nurse effectively. No big deal, right?

For first time moms, this can be the straw that breaks the milkmaid’s back.

What are the other straws, you say? Well, the Titty Fairy bestows these gargantuan boobies on you overnight, literally. Your netherlands are still bulging and weeping. You haven’t slept in days. And now you have to somehow shove a nipple the size of a yarmulke into your baby’s teeny, tiny mouth.


Enter the lactation consultant. In order to properly maneuver your 8 pound baby onto your 10 pound breast, she will need to fondle you, and I mean that with all the professional respect that these women deserve.

Just surrender to the process, be happy such help exists with a lactation consultant, and enjoy being boob-a-li-cious while it lasts.



Why Direct Pay Health Care Is Becoming America’s ‘Go-To’

Posted: 28 days ago in Health Wellness


divider2Your primary care provider can be thought of as a key that unlocks a variety of different doorsdoors that lead to specialists, imaging centers, lab facilities, and other therapies.

Wouldn’t it be handy to easily access this key right when you need it?  Instead of searching for it at the bottom of the “purse” that is life – kids, family, home maintenance, work, school?

In another fun analogy, primary care providers are like the general auto repair guys of the human body.  They can take a look at whatever creak, pop, gurgle, or leak you’ve got, and get a good idea of where it’s coming from, and what may be causing it.

Using this analogy, if your car broke down, you’d try to get your trusted mechanic to take a look at it.  But if you didn’t have a mechanic, you’d likely try to find the quickest place to have your car fixed.  This scenario plays out frequently when it comes to health care, with a patient needing to be seen quickly for an acute issue and not being able to get an appointment with their primary care doctor.  Due to crammed schedules, it’s increasingly more difficult to be seen same day, so more and more patients are turning to urgent care and emergency rooms for issues that could be easily managed by a primary care provider.  This contributes to higher health care costs, and ties up emergency room providers who have true emergencies to take care of.

The best case scenario is one in which you, the busy wife/mom/small business owner, can get in to see your provider at the exact moment you need them.

In what world is that a possibility, you ask?

Well that dream is quickly becoming a reality for more and more patients who are finding affordable direct pay primary and urgent care offices popping up around the country.  The concept of direct pay health care is exactly as it sounds – you pay your provider up front for services rendered, eliminating the “middle man” of insurance companies. 

What’s great about this is that while the term “concierge medicine” brings to mind images of doctors flying private jets to mansions in Nantucket or the Hamptons, direct pay models come with concierge-level quality and access at prices any working mom/wife/small business owner can afford.

moneyAs mandated by the Affordable Care Act, Americans are required to carry insurance or pay a fine.  These insurance plans do help provide coverage for millions of people and guard against catastrophic medical debt, but often times the deductibles are prohibitively high, keeping even the most simple and basic preventative care out of reach.

With many direct pay providers, patients pay a low monthly membership rate, around the cost of your daily latte, to get a low or no-cost visit anytime they need to be seen.  For those seeking an extreme level of convenience and access, these newer practices may even offer virtual visits 24/7 so you never have to leave work, or the circus that you call home, in order to meet with your doctor.

The importance of establishing a relationship with your primary care provider can’t be overstated.  In addition to better preventative care and continuity of your overall personal care, primary care doctors are a key resource to avoiding a potential trip to the ER for that raging UTI or sinus infection. They may recommend a treatment plan that you can carry out at home using over-the-counter medications, or a prescription to treat your condition. A lot of primary care providers can also suture cuts, remove suspicious moles, perform well-woman examinations, and screen you for chronic conditions like diabetes and heart disease.

So when a terrible bronchitis strikes you in the middle of the night and you know you can’t leave the kids to get to the doctors’ office, a concierge or direct pay model may be the best fit for your lifestyle, your wallet, and your health.

Kastle Donovan

About Kastle Donovan

Kastle Donovan grew up in Danville, CA and planned on staying in California for life. That plan changed with a chance to attend the George Washington University, where she obtained a BS in Biology and met her husband, an Annapolis native. After becoming a registered nurse, Kastle worked in the trauma intensive care unit at Inova Fairfax Hospital for 6 years. She received her Master's in Nursing from Marymount University in Arlington, VA, and then moved to Annapolis. After three years treating a variety of acute and chronic illnesses at a local internal medicine practice, Kastle had the opportunity to help develop a brand new direct pay practice in Annapolis. Evolve Medical Clinics opened with great fanfare in July of 2014. This concept of concierge-level primary care and urgent care at affordable prices has brought a wonderful patient base to the practice, and Kastle enjoys spending lots of time with her patients, giving them the respect and care they deserve. In her free time, Kastle enjoys reading, barre and spin, and art/music/gym classes with her toddler, as well as watching the Washington Capitals with her husband.

Oh No She Didn’t…

Posted: 29 days ago in Everything Else Inspiration


I Need to Pull-Up My Pantyhose, But I’m Not Wearing Any!

Posted: 34 days ago in Mirror Mirror

pantyhoseThere is a large mirror in my front hall.

After a run one sunny day, I caught a glimpse of myself in a tennis skirt. — (I don’t play tennis, but I wear tennis skirts to run in. Reference my post, ‘To Go or Not To Go…Commando” and you’ll understand why). — Anyways, my immediate thought was that I really needed to pull up my pantyhose; never mind that I haven’t worn any since 1990 when I’d taken my last National Board exam.

Though I was looking lean that day, my thighs were sagging. That’s right, SAGGING! Who knew thighs could sag?

Boobs? Sure. Neck? Yup. But my freaking THIGHS?!

As far as my share of life’s stages go, I think my thighs went straight from the “so plump the heat index rises when you walk” look, to the “blown-out balloon” look. I don’t think I even got one bathing suit season worth of, “wow, she’s got some great legs!” Life can be so unfair (and God, I know there are much bigger burdens than saggy thighs, and you know I’ve juggled my share of those, so let me just say… I’m grateful I don’t have more).

We all need to resign ourselves to the fact that as we age, the supporting structure of our skin – a.k.a. collagen – starts to wane. You ever lay eyes on an individual pushing one hundred-years-old? They didn’t go from baby bottoms to saggy drawers in one day; it’s a part of life!

Things like sun exposure, smoking and a poor diet can accelerate this. Yo-yo dieting also contributes to saggy skin, hence the balloon reference. In my case sun exposure and weight fluctuations over 4+ decades have taken their toll. But would I trade my life for tighter thighs?

Let’s see…

Although my weight has been up and down all throughout my life, pregnancy was by far the greatest contributing factor to my chubby thighs. Bring it on. I have two beautiful daughters because of it. How about the sun exposure? I’m sure to take some hits for this, but I love the sun. My dad was Italian and thankfully, he passed on his olive skin to yours truly. My dermatologist gives me a once-over annually, and I wear sunscreen…most of the time. But I love the beach, and maintain that tan fat is way better than pale fat. So, all things considered; no. I wouldn’t trade my countless days of loving life at the beach with my family for skin that doesn’t resemble a Birkin bag.

Like most things in life, I strive to find a happy balance, but you can be sure that when given the choice between sitting on the sidelines and diving in, you won’t find me on the bench. And I take the repercussions of my choices with a big smile, sunspots, saggy thighs and all.

I suggest you do the same!

Hemorrhoids: 6 Ways to Reduce Your Discomfort

Posted: 38 days ago in Health Wellness


My butt hurts and hemorrhoids are to blame.  

Those of you who have been reading my stuff for a while know I am good for sharing TMI, including Another Childbirth Bonus. I’m not pregnant, nor is this a case of ‘Same Sh*t, Different Day.’

Yet, I have a freaking hemorrhoid.  453851401

For those of you unfamiliar with those little darlings, hemorrhoids are bulging veins in and around your anus and rectum. They can itch, bleed and hurt, and make it virtually impossible to wear thong underwear.

Hellllllllo, visible panty lines. What is the deal??!

Since none of the causes of hemorrhoids currently apply to me, the deal just might be that getting old, frankly, can suck.

Hemorrhoids can be caused by:

  • Straining during bowel movements
  • Sitting for long periods of time on the toilet
  • Chronic diarrhea or constipation
  • Obesity
  • Pregnancy
  • Anal intercourse
  • Low-fiber diet

They are also more likely to happen as we age, as the tissues that support the veins, as well as the veins themselves, can weaken and stretch with age.

Well isn’t that just freaking fantastic.

There is no cure, per se, for hemorrhoids, but there are some things you can do to minimize your discomfort and make the swelling go down – for now:

  1. Keep squeaky clean down there! After bowel movements, use an alcohol-free baby wipe to gently cleanse the area, as dry toilet paper can be very abrasive. And as a side note: please don’t flush the baby wipe as it may clog the toilet!
  2. Bathe daily and wear clean, non-thong underwear with a cotton crotch.
  3. Use a home-made or store-bought witch hazel pad, like Tucks brand. These can be incredibly soothing, and I guess since they call them Tucks, you can tuck ‘em right up in there for a bit for some extra relief. Plus, I love their tagline, ‘love the butt’. Couldn’t agree more… p.s. this is not a paid endorsement.
  4. Sitz baths with a little Epsom salts can help.
  5. I’m a big fan of ice packs so here’s the ‘how-to’ on that: put on some granny panties (you know you have them in the back of your drawer), then tuck a soft ice pack way up against your butt where the hemorrhoids are. Then, to hold it in place, put another pair of snug-fitting panties on top of the ice pack. Works wonders for hemorrhoids, and for your girl parts after childbirth, too!
  6. Hemorrhoid creams like Preparation-H contain hydrocortisone, which is very effective at decreasing the swelling.

If those suckers just won’t go away, and/or won’t stop bleeding, though, you may need to visit your doctor….and you won’t be happy with what s/he has to offer you, so get those suckers under control now!

Good luck with that!