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		<title>What frugality has taught me: 48 things</title>
		<link>http://www.managingcontraception.com/newsevents/?p=136</link>
		<comments>http://www.managingcontraception.com/newsevents/?p=136#comments</comments>
		<pubDate>Thu, 26 Aug 2010 13:01:03 +0000</pubDate>
		<dc:creator>June</dc:creator>
				<category><![CDATA[Dr. Bob Hatcher]]></category>

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		<description><![CDATA[Frugality can teach some important life lessons.]]></description>
			<content:encoded><![CDATA[<p><strong>Frugality can teach some important life lessons.</strong></p>
<p><em>Today, let’s do something a little different. I’m going to list 48 things I’ve learned about myself and the world around me that I only discovered thanks to frugality.</em></p>
<p> </p>
<p><strong>Trent Hamm</strong></p>
<p><strong><em>The Simple Dollar is a blog for those of us who need both cents and sense: people fighting debt and bad spending habits while building a financially secure future and still affording a latte or two. Our busy lives are crazy enough without having to compare five hundred mutual funds – we just want simple ways to manage our finances and save a little money.</em></strong></p>
<p><strong><em> </em></strong></p>
<p>1. I really like sun tea.</p>
<p>2. The patience and effort in teaching yourself something new is incredibly rewarding when you begin to succeed at it (like my piano playing).</p>
<p>3. When you’re sitting around a table with friends, it really doesn’t matter where you’re at.</p>
<p>4. Young children are usually more interested in the free packaging or other freebies than any item you might buy them.</p>
<p>5. A tall glass of pure water is the best first line of defense for many ailments.</p>
<p>6. Going nearly vegetarian when your garden is peaking in productivity is an interesting dietary adventure.</p>
<p>7. You don’t have to go to a dealership to buy a great car.</p>
<p>8. Fixing a toilet isn’t nearly as scary as it sounds.</p>
<p>9. Making a small sample batch of something before you make it in bulk is a really good idea.</p>
<p>10. You disagree with your spouse a lot less if you don’t have a pile of debt stressing you out.</p>
<p>11. Your tube and a pile of old newspapers can entertain a four year old and a two year old for several hours.</p>
<p>12. Real friends keep in touch no matter where your path leads.</p>
<p>13. I used to be ashamed of who I was and bought stuff to cover it up. Then I was ashamed of who I used to be and flaunted my frugality. Now I’m okay with both and I don’t really care at all.</p>
<p>14. You feel pretty good when you’ve fixed a hot water heater problem by yourself without having to call a repairperson.</p>
<p>15. Every time I let go of something I used to like, I have more room for the things I enjoy now.</p>
<p>16. Our local library has more groups going on that I could possibly be involved with.</p>
<p>17. When you’re spending time with people you really care about – and who really care about you – it doesn’t matter what you’re actually doing.</p>
<p>18. Most generics are just as good as the name brands; they’re like getting a $1 off coupon because the label looks funny.</p>
<p>19. Preparing something new in the kitchen and actually pulling it off makes our family dinner incredibly enjoyable.</p>
<p>20. You don’t have to worry about the important stuff if you don’t waste time and money on stuff that isn’t really important to you.</p>
<p>21. Our city’s parks and recreation department has more fun stuff going on than our family has time to participate in.</p>
<p>22. Netflix streaming (at $9 a month) combined with free over-the-air digital television provides better television viewing options than a $50 monthly cable bill.</p>
<p>23. Changing your own oil isn’t nearly as scary as it sounds.</p>
<p>24. Life is a lot less stressful when you don’t really care what the people at the grocery store think of you.</p>
<p>25. The flavor of fresh vegetables and herbs from the garden blows away anything you can buy at the store.</p>
<p>26. You don’t need all of the latest and greatest equipment to really enjoy a hobby.</p>
<p>27. A nap is the best free vacation.</p>
<p>28. Vinegar is a spectacular fabric softener replacement.</p>
<p>29. Haggling can be a lot of fun.</p>
<p>30. It’s a lot easier to focus on earning more money and doing something spectacular if you’re not scared to death of the financial apocalypse from losing your job.</p>
<p>31. I like putting beans in a lot of different kinds of food.</p>
<p>32. Being thrifty isn’t bad for the economy – it’s just a different kind of consumption. Money saved and invested helps the economy as much as money spent.</p>
<p>33. Making your own gifts for other people can be incredibly rewarding, both for you and for the recipient.</p>
<p>34. Saying or thinking “I absolutely won’t…” usually costs you money.</p>
<p>35. Getting rid of stuff you don’t use can be painful, but it feels exhilarating once you’ve started doing it.</p>
<p>36. It’s far better to own one thing that works than ten things that only “kind of” work.</p>
<p>37. The fun stuff you enjoy doing isn’t tinged with guilt when you’re not buried in debt while doing that fun thing.</p>
<p>38. Cloth diapering isn’t as scary as it sounds.</p>
<p>39. Sharing a good money-saving tip or two is almost always a good way to start a conversation with a neighbor.</p>
<p>40. The less activities you jam into a vacation, the more enjoyable and relaxing it usually is.</p>
<p>41. The more you talk to children about money and wise money decisions, the more they emulate those decisions with the money they have.</p>
<p>42. If you have the storage space, you’re almost always better off buying in bulk.</p>
<p>43. You are never too old to run through a cold sprinkler on a hot day.</p>
<p>44. Used paperbacks and books from the library are just as fun to read as new books from the bookstore.</p>
<p>45. Taking out your old thermostat and putting in a new one isn’t as scary as it sounds.</p>
<p>46. A bit of patience on any purchase almost always saves you a mint.</p>
<p>47. Time is far, far more valuable than money.</p>
<p>48. Most of the things that genuinely make me feel good – exercising, playing with my kids, holding my wife – don’t cost anything at all.</p>
<p>What has frugality taught you?</p>
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		<title>Be prepared to change quickly&#8230;</title>
		<link>http://www.managingcontraception.com/newsevents/?p=133</link>
		<comments>http://www.managingcontraception.com/newsevents/?p=133#comments</comments>
		<pubDate>Thu, 15 Jul 2010 21:00:45 +0000</pubDate>
		<dc:creator>June</dc:creator>
				<category><![CDATA[Dr. Bob Hatcher]]></category>

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		<description><![CDATA[Today, observe yourself with this question in mind:
Is there something I am being exposed to this day that could change the entire course of my life?

]]></description>
			<content:encoded><![CDATA[<p><strong>It is fascinating how our lives can change on a dime and we must be ever vigilant to receive new signals suggesting new possibilities, new opportunities, new relationships and new ways of looking at the world.  </strong></p>
<p><strong>Author, </strong><strong>Alice Hoffman</strong><strong>, gave the commencement address at Adelphi University in Garden City, New York earlier in this decade. </strong></p>
<p><strong>Here are some of Alice Hoffman’s words about one brief morning when she was a teenager, a morning that changed the entire direction of her life:</strong></p>
<p><strong><em>“I’m a local girl. I grew up down the street and around a few corners. When I was growing up on Long Island, I never expected to go to college&#8230; The real world for me was a job at the Doubleday factory here in Garden City. I was hired to file, and I was advised I had better be fast out in the real world. </em></strong><strong><em> </em></strong></p>
<p><strong><em>The year was 1969, and at that time employees in my office could not go to the rest room without permission. Our coffee break was announced by the ringing of a bell.</em></strong></p>
<p><strong><em>Women were expected to wear skirts, hosiery, sensible shoes. There was to be no talking. There was to be serious filing. I lasted until lunch.</em></strong></p>
<p><strong><em> At</em></strong><strong><em> noon, I walked away from my job at the factory and drove directly to Adelphi’s admission office. I began as a non matriculated student, but I finished my course work in three years and went to the writing program at Stanford University. </em></strong><strong><em> </em></strong></p>
<p><strong><em>It was a thrill when I sold my first novel, but it wasn’t the defining moment of my life. Coming to Adelphi was the most important day in my life.</em></strong><strong><em> </em></strong></p>
<p><strong><em>It is particularly satisfying that my next novel will be published in the summer of 2003 by Doubleday.</em></strong></p>
<p><strong>This next month thousands of young people will start on a new year in school. It may be the first year in high school, college, medical school or business school.</strong><strong>  </strong><strong>August and September are times of so many beginnings. So many new people. So many new topics to learn about. </strong></p>
<p><strong>The above story is the entry for July 17<sup>th</sup> in my book </strong><strong><em>Something Nice to do 365 Days a Year. </em></strong><strong> I write in this book most days jotting down people, places and ideas that have excited me. It is one of several ways a person can keep a journal. You can get this book at Grapes and Beans, the Timpson Creek Gallery, the Main Street Gallery or at Praeter’s Bookstore.</strong><strong> </strong></p>
<p><strong>Today, observe yourself with this question in mind:</strong><strong><em></em></strong></p>
<p><strong><em>Is there something I am being exposed to this day that could change the entire course of my life?</em></strong></p>
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		<title>Doubt is Helpful&#8230;Certainty is Dangerous</title>
		<link>http://www.managingcontraception.com/newsevents/?p=124</link>
		<comments>http://www.managingcontraception.com/newsevents/?p=124#comments</comments>
		<pubDate>Wed, 30 Jun 2010 13:02:26 +0000</pubDate>
		<dc:creator>June</dc:creator>
				<category><![CDATA[Dr. Bob Hatcher]]></category>

		<guid isPermaLink="false">http://www.managingcontraception.com/newsevents/?p=124</guid>
		<description><![CDATA[So life presents us with this very difficult challenge: while it is important to have in mind what we want to accomplish, what we believe in and what we think is right, at the same time we must always be aware of the fact that we may need to tweak our perception of the truth and of our best course of action. Who ever, ever, ever said that life was going to be easy?]]></description>
			<content:encoded><![CDATA[<p><strong>We have a tendency to look suspiciously at ourselves or others who move slowly, with caution or only after checking and rechecking all the possibilities. Doubt, one might think, is a sign of weakness or fear.</strong></p>
<p><strong>At lunch recently, one of my Rabun County heroes, Pierce Cline, came to Grapes and Beans with several handwritten thoughts and phrases he wanted us to discuss.  One was the wisdom or folly of these six words:</strong><strong> </strong><strong><em>“Doubt is healthy.</em></strong><strong><em> </em></strong><strong><em>Certainty is dangerous.”</em></strong></p>
<p><strong>Pierce decided at age 60 to climb the Appalachian Trail from Springer Mountain, Georgia to Mount Katahdin, Maine.  He did not have much doubt but that he could accomplish this remarkable objective. He planned to hike the entire 2,178 miles in sections.  He would do this over a number of years.  Along the way, he would pass through </strong><strong>Georgia</strong><strong>, North Carolina, Tennessee, West Virginia, Maryland, Pennsylvania, New Jersey, New York, Connecticut, Massachusetts, Vermont, New Hampshire and Maine.</strong></p>
<p><strong>Along the way Pierce learned over and over again that he was really rich</strong><strong>. </strong><strong><em>“On the trail I have learned that everything I truly need I can carry on my back.”</em></strong></p>
<p><strong>Piece had hiked all over the world for decades with a group of close friends which explains why he was quite certain that in time he would be successful  in accomplishing his remarkable goal.  Just a bit of doubt crept into the picture when he needed cardiac bypass surgery several years later. That derailed him for a year, but then he returned to the trail and he accomplished his goal.</strong></p>
<p><strong>For a long while now when thinking about myself or another person, the phrase </strong><strong><em>“sometimes wrong but never in doubt”</em></strong><strong> </strong><strong>has basically had negative connotations to me. Not always, but usually.</strong></p>
<p><strong>Perhaps, in parallel with the words in Ecclesiastes, we might suggest that there is a time for doubt and a time for putting aside one’s doubts.  There is a time for certainty and a time to make decisions slowly.</strong></p>
<p><strong>Some examples of certainty carried to dangerous and evil extremes are the lives of Adolf Hitler, Mao, Joseph Stalin, and members of “the family” in Washington. If you haven’t read the book, “The Family” I recommend it highly.</strong></p>
<p><strong>So life presents us with this very difficult challenge: while it is important to have in mind what we want to accomplish, what we believe in and what we think is right, at the same time we must always be aware of the fact that we may need to tweak our perception of the truth and of our best course of action. Who ever, ever, ever said that life was going to be easy?</strong></p>
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		<title>WHERE THINGS START</title>
		<link>http://www.managingcontraception.com/newsevents/?p=117</link>
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		<pubDate>Fri, 18 Jun 2010 12:36:19 +0000</pubDate>
		<dc:creator>June</dc:creator>
				<category><![CDATA[Dr. Bob Hatcher]]></category>

		<guid isPermaLink="false">http://www.managingcontraception.com/newsevents/?p=117</guid>
		<description><![CDATA[Open primaries give stronger voice to largest political group - moderates.]]></description>
			<content:encoded><![CDATA[<p><strong>          </strong><strong>In the book </strong><strong><em>Megatrends</em></strong><strong>, it is suggested that major trends start locally and spread nationally while fads start nationally and spread down to localities.</strong></p>
<p><strong>          John Naisbitt demonstrates that major trends begin in 5 bellwether states. He later added a sixth. You might ask yourself before reading the rest of this column, what are those 6 states? What are the six states where so many major trends begin in our country?</strong></p>
<p><strong>Pause for a moment and ask yourself where you think most ideas start that are subsequently picked up nationally. Write those states down on a piece of paper.</strong></p>
<p><strong>Salad bars started locally and spread nationally.  Where do you think they might have begun? It is the #1 state for new trends. Salad bars began in California as did McDonalds, the granola craze, most of the human potential groups and the physical fitness trend.</strong></p>
<p><strong>Florida is the #2 state for new trends bringing to us the boom in condominiums, time-shared vacations, “sunshine laws” that required public agencies to hold open meetings and have since spread to almost every state, and many approaches to deal with the realities of our aging population.</strong></p>
<p><strong>Colorado passed the first laws limiting growth of population, highways, shopping centers and housing units (followed within 2 months by similar laws in Florida and California). Colorado also initiated “sunset laws” that closed down new agencies unless legislatures explicitly renewed them.</strong></p>
<p><strong>Connecticut</strong><strong>, Washington and Texas are the other states where new trends are particularly likely to begin.</strong></p>
<p><strong>On Election Day California joined the state of Washington by passing an open primary referendum</strong>. <strong>Washington went to the open primary concept whereby the top two vote getters in the primary, whatever their party, appear on the ballot in the general election. Last week California voters approved a similar process during their state&#8217;s primary.</strong></p>
<p><strong>Under the open primary system all who vote in a primary may vote for any of the candidates. Candidates may choose to list their party affiliation or not to list their party affiliation. Both parties or all parties can still raise money and campaign for their candidates. Then comes the primary vote and the top two move on to the general election in November. In some elections this will mean two Democrats in other districts two Republicans will be on the November ballot. . <br />
</strong><br />
<strong>Open primaries give stronger voice to largest political group – moderates.</strong></p>
<p><strong>This “top two” approach to determining who is on the ballot in November is certain to lead to law suits, extensive debate and strong consideration in other states. Whether it becomes a national trend, like so many other trends that started in Washington or California, will be fascinating to follow.</strong></p>
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		<title>If a woman becomes pregnant, should her IUD be removed?</title>
		<link>http://www.managingcontraception.com/newsevents/?p=115</link>
		<comments>http://www.managingcontraception.com/newsevents/?p=115#comments</comments>
		<pubDate>Sun, 13 Jun 2010 12:33:54 +0000</pubDate>
		<dc:creator>June</dc:creator>
				<category><![CDATA[Dr. Bob Hatcher]]></category>

		<guid isPermaLink="false">http://www.managingcontraception.com/newsevents/?p=115</guid>
		<description><![CDATA[If a woman becomes pregnant with an IUD in place, confirm that the pregnancy is intrauterine and not ectopic. Remove the IUD promptly, regardless of her plans for the pregnancy. Early removal reduces the risk of spontaneous miscarriage or preterm delivery should the woman plan to continue the pregnancy.  ]]></description>
			<content:encoded><![CDATA[<p>My sister is 9 weeks pregnant, but her IUD is still in place.  Should she have it removed or just keep it?  What will happen with her pregnancy if she leaves it in place?</p>
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<li><strong>If the strings of your sister’s IUD are still present at the opening of her cervix, her IUD should be removed</strong><em><strong><span style="text-decoration: underline;"> now</span></strong></em><strong> before those strings are drawn up into the uterine cavity</strong>.</li>
<li><strong>Removal of that IUD may lead to a miscarriage in about 25% of cases.</strong></li>
<li><strong>Leaving the IUD in utero leads to miscarriage in about 50% of cases and often those miscarriages are due to septic abortions, septic miscarriages that are potentially much more dangerous for the pregnant woman.</strong></li>
</ol>
<p><strong>   </strong><strong>BOTTOM LINE: </strong><strong>Recommend to your sister that her IUD be removed right now!</strong><strong> </strong></td>
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</tbody>
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<p><strong></strong></p>
<p><strong><em>Contraceptive Technology 19<sup>th</sup> Edition</em></strong></p>
<p><strong><em>Chapter 7.  Intrauterine Devices (IUDs) by David A. Grimes, MD</em></strong></p>
<h3><em>Pregnancy  </em></h3>
<p>If a woman becomes pregnant with an IUD in place, confirm that the pregnancy is intrauterine and not ectopic.<strong> </strong><strong>Remove the IUD promptly, regardless of her plans for the pregnancy. Early removal reduces the risk of spontaneous miscarriage or preterm delivery should the woman plan to continue the pregnancy.</strong>  If the woman plans to continue the pregnancy, she should be alerted to look for symptoms of an influenza-like syndrome, which might be manifestations of a <strong>septic spontaneous abortion</strong>. A copper or non-medicated IUD in place during pregnancy carries no known risk of teratogenesis. If the woman plans to have an induced abortion, remove the IUD promptly rather than wait for removal at the time of abortion.  </p>
<p>Today, May 28<sup>th</sup>, has your sister had her IUD removed yet? </p>
<p>(6-4-2010): We want to know where the IUD is and how your sister is doing.</p>
<p><strong>Key Words:  </strong>pregnant, IUD, in place, strings, cervix, removed, drawn-up, uterine cavity, miscarriage, septic abortions, dangerous, <strong>Contraceptive Technology, Dr. David Grimes</strong>, risk, preterm delivery</p>
<p><strong> </strong></p>
<p><strong>Reference:</strong></p>
<p>Grimes DA. Intrauterine devices (IUDs) IN Hatcher RA, Trussell J, Nelson AL. et al <strong>Contraceptive Technology</strong> 19<sup>th</sup> edition, page 125: Ardent Media Inc. 2008</p>
<p><strong> </strong></p>
<p><strong>Helpful Books:        </strong></p>
<p><strong><em>Contraceptive Technology 19<sup>th</sup> Edition</em></strong></p>
<p><strong><em>Managing Contraception 2007-2009</em></strong></p>
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		<title>The Botched Call in Detroit</title>
		<link>http://www.managingcontraception.com/newsevents/?p=110</link>
		<comments>http://www.managingcontraception.com/newsevents/?p=110#comments</comments>
		<pubDate>Sat, 12 Jun 2010 23:16:55 +0000</pubDate>
		<dc:creator>June</dc:creator>
				<category><![CDATA[Dr. Bob Hatcher]]></category>

		<guid isPermaLink="false">http://www.managingcontraception.com/newsevents/?p=110</guid>
		<description><![CDATA[The veteran ump regretted it.
“I just cost that kid a perfect game,” Joyce said. “I thought he beat the throw. I was convinced he beat the throw, until I saw the replay.”
]]></description>
			<content:encoded><![CDATA[<p><img class="aligncenter size-full wp-image-112" title="Armando Galarraga" src="http://www.managingcontraception.com/newsevents/wp-content/uploads/2010/06/Armando-Galarraga1.bmp" alt="Armando Galarraga" width="214" height="279" /></p>
<p><strong>A week ago, on June 2, 2010, Armando Galarraga was one out away from a perfect baseball game: 26 batters had been put out with no batter reaching first base safely.  One batter remained.  People sometimes ask what folks can learn from sports. Read on if this question has crossed your mind. </strong></p>
<p><strong>Larry Lage of the Associated Press describes what happened next: “First baseman Miguel Cabrera cleanly fielded Jason Donald’s grounder to his right and made an accurate throw to Galarraga covering the bag. The ball was there in time, and all of Comerica Park was ready to celebrate the 3-0 win over Cleveland, until Joyce emphatically signaled safe.</strong></p>
<p><strong>The veteran ump regretted it.</strong></p>
<p style="text-align: center;"><strong><img class="aligncenter size-full wp-image-119" title="Umpire Jim Joyce" src="http://www.managingcontraception.com/newsevents/wp-content/uploads/2010/06/Umpire-Jim-Joyce.bmp" alt="Umpire Jim Joyce" width="237" height="203" /><br />
</strong></p>
<p><strong>“I just cost that kid a perfect game,” Joyce said. “I thought he beat the throw. I was convinced he beat the throw, until I saw the replay.”</strong></p>
<p><strong>“It was the biggest call of my career,” said Joyce, who became a full-time major league umpire in 1989.”</strong></p>
<p><strong>What happened next is developing into the best good sportsmanship story I’ve heard of in a long while.  As I outline what happened next think of the central figures in the Gulf oil spill; the Democratic candidate for the Senate in Connecticut, who claimed repeatedly that he had fought in Vietnam when he hadn’t; and the born again Christian Republican Senator from Nevada, John Ensign, who paid close to $100,000 to the husband of staffer Cynthia Hampton, with whom he had had an eight month affair. </strong></p>
<p><strong>But perhaps most importantly, think about this botched call the next time someone makes a mistake that hurts you or you make a mistake that hurts someone else. </strong></p>
<p><strong>Here are some of the ways Armando Galarraga, umpire Jim Joyce, the Detroit manager, Jim Leyland, the Detroit Tiger fans, and even General Motors, responded to the botched call.</strong></p>
<p><strong>A smile rather than a scowl or an expression of pain came to the face of Armando Galarraga when he realized that the umpire had called the runner safe when he knew his foot had hit the bag first and the runner was out. He had failed in his goal to pitch a perfect game because of the umpire’s mistake.</strong></p>
<p><strong>The umpire thought he had made the right call, but when he saw the replay on tape he said he had blown the call.</strong></p>
<p><strong>In expressing his disappointment with himself, Joyce went on to say that this was the biggest call of his life and that he would be remembered for getting the call wrong.</strong></p>
<p><strong>Jim Leyland, the much respected manager of the Detroit Tigers, whose young pitcher had just lost his perfect game, pointed out that the umpire was actually a great umpire and that everyone makes mistakes.</strong></p>
<p><strong>Although booed lustily by the fans when he left the field after the game, the umpire handled himself so well in the next 24 hours that the next night when he came onto the field he was greeted by loud applause not jeering by the Detroit Tiger fans. </strong></p>
<p><strong>And what did Joyce say of criticisms aimed his way: </strong><strong>“I don’t blame them a bit for anything that was said,” Joyce said. “I would’ve said it myself if I had been Galarraga. I would’ve been the first person in my face, and he never said a word to me.”</strong></p>
<p><strong>General Motors gave Armando Galarraga a new car at the start of the next night’s game.</strong></p>
<p><strong>And perhaps most poignant, the next night Detroit manager, Jim Leyland, gave the starting lineup card to Galarraga to carry out to the home plate umpire.  The home plate umpire, Jim Joyce, accepted the card with his face down and brushing off tears. As Galarraga walked off Joyce gave him a gentle fist pump to his shoulder.</strong></p>
<p><strong>The world learned much about responding to a mistake and forgiveness at the end of a baseball game in Detroit on June 2, 2010.</strong></p>
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		<title>The Best in the World</title>
		<link>http://www.managingcontraception.com/newsevents/?p=106</link>
		<comments>http://www.managingcontraception.com/newsevents/?p=106#comments</comments>
		<pubDate>Sat, 12 Jun 2010 22:54:08 +0000</pubDate>
		<dc:creator>June</dc:creator>
				<category><![CDATA[Dr. Bob Hatcher]]></category>

		<guid isPermaLink="false">http://www.managingcontraception.com/newsevents/?p=106</guid>
		<description><![CDATA[The CHOICE project will soon be telling the world of lower contraceptive discontinuation rates, higher levels of satisfaction, lower rates of pregnancy and lower rates of repeat abortion with the “you can’t forget me methods.”]]></description>
			<content:encoded><![CDATA[<p style="text-align: left;"><strong>It is exciting whenever one has the opportunity to see the best.  Like Rabun Wright, Eva Lathrop and Dr. Skoot Dimon whom I described last week’s article.  Like Caroline White whom I get to work with each week. Like my wife, Maggie, the incredible gardener, whom I get to live with every day. Like Dr. Ward Cates, whose enthusiastic encouragement brings out the best in all around him. And like Steve Hall, my favorite minister of the past 6 decades. So, to all of you, thank you.  Your excellence has made my days better days.</strong></p>
<p style="text-align: left;"><strong>Each of us is in contact with the best from time to time and all too often we see it, focus on it for several moments, say “great,” and move right on without really celebrating what we have seen. </strong></p>
<p style="text-align: left;"><strong>Well, on May 19, 2010, I saw the best up close and personal when I visited the CHOICE project in the Department of Obstetrics and Gynecology at Washington University in St. Louis. </strong></p>
<p style="text-align: center;"><strong><img class="aligncenter size-full wp-image-130" title="Final Choice Logo" src="http://www.managingcontraception.com/newsevents/wp-content/uploads/2010/06/Final-Choice-Logo.JPG" alt="Final Choice Logo" width="190" height="145" /><br />
</strong></p>
<p style="text-align: left;"><strong>And these words, “the best family planning program in the world” are not just hyperbole. These words are not said just because the person who developed this program, Dr. Jeffrey Peipert, was an Emory Medical School graduate whom I was privileged to work with for protracted periods of time early in his career. They are objectively the truth and the research papers coming out of this program will prove this.</strong></p>
<p style="text-align: left;"><strong>On May 20<sup>th</sup>, on my return from St. Louis to Tiger, Georgia, I read a remarkable article on family planning by Nicholas D. Kristof in the New York Times. He writes about Poverty and the Pill. </strong></p>
<p style="text-align: left;"><strong>Kristof begins with these words: “Earthquakes are more dramatic. Tsunamis make better television. AIDS is more visceral. </strong></p>
<p style="text-align: left;"><strong>“But here’s a far more widespread challenge, one that’s also more fixable: the unavailability of birth control in many poor countries.”</strong></p>
<p style="text-align: left;"><strong>Kristof says later in his opinion piece: “If contraception were broadly available in poor countries, more than 50 million unwanted pregnancies could be averted annually. One result would be 25 million fewer abortions per year. Another would be saving the lives of as many as 150,000 women who now die annually in childbirth.”</strong></p>
<p style="text-align: left;"><strong>So why is the St. Louis CHOICE project the best?</strong><strong> Why could programs like the CHOICE project change the family planning landscape worldwide? CHOICE has provided completely voluntary contraceptive services to Just over 6,000 women. Mirena IUDs have been chosen by 46.9% of the women. This is the IUD that decreases menstrual blood loss by 90% (decreasing anemia in women using this IUD) and markedly decreases menstrual cramps and pain.  Mirena provides the most effective contraception of any reversible contraceptive for 5 to 7 years. </strong></p>
<p style="text-align: center;"><img class="aligncenter size-full wp-image-121" title="newmirenaIUD" src="http://www.managingcontraception.com/newsevents/wp-content/uploads/2010/06/newmirenaIUD.bmp" alt="newmirenaIUD" width="182" height="182" /></p>
<p style="text-align: left;"><strong> </strong></p>
<p style="text-align: left;"><strong>Another 10.5% of CHOICE women have chosen the copper IUD, called ParaGard.  This IUD provides excellent contraception for 12 years.  And 12.4% of women have left the CHOICE clinics using an Implanon implant that lasts for 3 years. </strong></p>
<p style="text-align: center;"><img class="aligncenter size-full wp-image-131" title="clip_image002" src="http://www.managingcontraception.com/newsevents/wp-content/uploads/2010/06/clip_image002.gif" alt="clip_image002" width="205" height="228" /></p>
<p style="text-align: center;"><img class="aligncenter size-full wp-image-127" title="ParaGardIUDhand" src="http://www.managingcontraception.com/newsevents/wp-content/uploads/2010/06/ParaGardIUDhand.bmp" alt="ParaGardIUDhand" width="169" height="122" /></p>
<p style="text-align: left;"><strong>These 3 methods, used by 69.8% of CHOICE patients, are called the LARC methods, the methods that are </strong><strong>Long Acting Reversible Contraceptives. </strong><strong>Others have called these 3 contraceptives the </strong><strong>“You can’t forget me methods”</strong><strong> because once in place there is nothing a woman needs to do to remain protected against an unwanted pregnancy. </strong></p>
<p style="text-align: left;"><strong>The CHOICE project will soon be telling the world of lower contraceptive discontinuation rates, higher levels of satisfaction, lower rates of pregnancy and lower rates of repeat abortion with the “you can’t forget me methods.” </strong></p>
<p style="text-align: left;"><strong>I also hope to tell you in another article about the woman whom Jeff Peipert calls “my boss,” Gina Secura. Gina manages the team of 50 clinicians and research assistants</strong><strong> collecting data from the women in this superb contraceptive program. </strong></p>
<p style="text-align: left;"><strong>Aside from their love and concern and wisdom, Gina and Jeff may have their hands on the most detailed information of any contraceptive program in the past decade.  The devil is in the details and Gina is on top of the details. She is one of the major reasons why this program is the best family planning program in the world.</strong></p>
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		<title>&#8220;Mr. Hatcher is a 72 year-old gentleman&#8230;&#8221;</title>
		<link>http://www.managingcontraception.com/newsevents/?p=104</link>
		<comments>http://www.managingcontraception.com/newsevents/?p=104#comments</comments>
		<pubDate>Sat, 15 May 2010 20:52:29 +0000</pubDate>
		<dc:creator>June</dc:creator>
				<category><![CDATA[Dr. Bob Hatcher]]></category>

		<guid isPermaLink="false">http://www.managingcontraception.com/newsevents/?p=104</guid>
		<description><![CDATA[“Today is the day the Lord hath made: rejoice and be glad in it.”
]]></description>
			<content:encoded><![CDATA[<p><strong>The other day I was being seen by a delightful nurse practitioner, Paige Hammonds.  She was reviewing my past history at Emory and pointed to my chart and said “I see here that you….”</strong></p>
<p><strong>Well, what my eyes went to was the first line of the paragraph she was looking at.  It started with the words:  “Mr. Hatcher is a 72 year-old gentleman who…” It took me right back to my third year of Cornell Medical School in 1961 when I was 24 years old.   I could remember starting histories with similar words. When seeing someone over 70 I would think “How old can a person possibly be?” I could not imagine myself ever being as old as 72.  I was just 2 years away from having wrestled, played football and running sprints for the Williams College track team. I couldn’t think that far ahead, to the day when I would be 72. I laughed out loud! I told Paige how I would have felt writing down a similar history 48 years ago.  She laughed too.</strong></p>
<p><strong>And here I am now: 72 years old and loving every single day of the adventure.</strong></p>
<p><strong>At times I do feel a bit like the Velveteen Rabbit. The edges of my body have become torn and tattered a bit. On my 63<sup>rd</sup> birthday I had a complete rupture of my Achilles tendon that has recurred slightly several times since.  I have survived a small melanoma. Occasionally my left hip hurts a bit.  Cataract surgery returned my vision back to Technicolor (important to me as much as I love the bright colors of gardening). And then there was that mitral valve that needed a major repair job a year ago.</strong></p>
<p><strong>Excellent care at Emory and from my orthopedic friend, Dr. Ed Loughlin, as well as incredibly wonderful support from family and friends, has made all of this medical business relatively atraumatic. </strong></p>
<p><strong>But </strong><strong><em>“Mr. Hatcher is a 72 year-old gentleman” really was a moment of truth.”</em></strong><strong> </strong><strong>I am 72 and I continue to laugh at my response to it. It was fun and it still is!</strong></p>
<p><strong>Recently I have discussed with a number of people their feelings about their age. They have shared their response to being 60 or 70 or 80 or more. A common response is for them to point out that one can be quite grateful to have reached these ages.  And this is exactly where I am too.  I consider each day a blessing and if I should live ‘til the day when a medical student’s history begins with the words, “Dr. Hatcher is a 90 year-old man who comes to the hospital complaining of…” I’m sure I will have the same response. WOW, when I was in medical school I couldn’t imagine being 90. </strong></p>
<p><strong>I do know one such soul quite well, my mother in law, Katie Hutchison.  She celebrated her 90<sup>th</sup>birthday just recently.  Each Tuesday, the day I work down at Grady in Atlanta, I spend the night at Katie’s home after we either go out to dinner, she cooks one of her delightful dinners or I bring in something to eat from the OK Café.  What an amazing lady. What a blessing she is to me and to those about her.  What energy.</strong></p>
<p><strong>So, say a toast to the day ahead of you and as the plaque my daughter sent me for my 50<sup>th</sup> birthday </strong><strong>says: </strong><strong><em>“Today is the day the Lord hath made: rejoice and be glad in it.”</em></strong></p>
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		<title>Motivated People Only!</title>
		<link>http://www.managingcontraception.com/newsevents/?p=86</link>
		<comments>http://www.managingcontraception.com/newsevents/?p=86#comments</comments>
		<pubDate>Wed, 05 May 2010 15:13:12 +0000</pubDate>
		<dc:creator>June</dc:creator>
				<category><![CDATA[Dr. Bob Hatcher]]></category>

		<guid isPermaLink="false">http://www.managingcontraception.com/newsevents/?p=86</guid>
		<description><![CDATA[From Hatcher's Pond: from the artist, Lucinda Bunnen]]></description>
			<content:encoded><![CDATA[<p><strong>Here are some words I have written to myself, inspired by a sign developed by HYPERFIT USA in Ann Arbor, Michigan, a remarkable fitness program I had the opportunity to visit with my daughter, Carrie and her husband, Josh, over Christmas.  These words have been changed from Hyperfit’s words, but most of the tone of their exhortation remains.</strong></p>
<p><strong><em>“As you venture forth, Bob, on the endeavor of this specific hour, or even part of an hour, this writing project, this article for the Clayton Tribune,  this question being answered for the website, </em></strong><a href="http://www.managingcontraception.com/"><strong><em>www.managingcontraception.com</em></strong></a><strong><em>, this time of meditation, this lecture, this interview, or this task in the garden you love so much, agree to give 100% of what you have. Let there be no excuses for failing to do your best. Remember that there may be no second chance. Every moment of every day is an opportunity to excel, to express love, to be the very best that you can be and to be more than you were before.  Life is simply not a dress rehearsal.  Do not squander your time by simply going through the motions.  Train, think, write or garden to the very best of your ability, but get results. At the end of the day, look in the mirror and ask yourself if you gave this day your all. If you don’t have this level of commitment, reconsider the venture you are considering setting forth upon.  If you don’t have this level of commitment maybe you shouldn’t set forth on this venture at all.  It may be a waste of time” </em></strong></p>
<p><strong>Over and over Lucinda Bunnen returned to the little pond below our house with an incredible level of commitment.  For the most part she returned when the lotuses had died and what was visible were the pods, the stalks, (sometimes as long as 3 feet up above the water, but now bent over in interesting angles by the weight of the pods), and an occasional dried up leaf. </strong></p>
<p><strong>Her return to this scene mystified me.  What was she seeing? Well, she was seeing what her genius as an artist saw. </strong></p>
<p><strong>You can see it too in Atlanta at the Museum of Contemporary Art (MOCA). Her huge photos (just over 6 feet by just under 5 feet) are on display from now through July 3, 2010.  The museum is at the end of Bennett Street (75 Bennett Street) just off Peachtree. </strong></p>
<p><strong><em>From Hatcher’s Pond:</em></strong><strong><em> From the Artist</em></strong><strong> </strong><strong>describes some of Lucinda Bunnen’s thoughts explaining her photos: “At Hatchers Pond I realized I was seeing something I hadn’t seen before and I started coming back as often as I could, to see the pond in different seasons, times of day, weather and light conditions.  When the first winter season came I got really excited by the many possibilities and started to see more and more patterns and feel the meditative pull. I tried to keep my mind and eye open to things I didn’t recognize and allow the camera and lens to show me things I hadn’t seen.</strong></p>
<p><strong>During my second winter I went when it was 17 degrees.  It was bone cold and so was I; but I was determined not to think about that and make new images. </strong></p>
<p><strong>I hope that the transparency of my images of the lotus stalks and pods reflecting in the water with earth and sky will give you, the viewer, an emotional jolt.</strong></p>
<p><strong>In Hatcher’s pond the reflection of the stalks and pods, sometimes looking like dancing figures and other</strong><strong> times like </strong><strong>musical scores, are the culmination of all my photographic desires in one of the most rich and exciting places.</strong></p>
<p><strong>Lucinda Bunnen, you are a creative genius and your exhibit has made Maggie and Bob Hatcher look upon the little pond below our home, with new eyes.  Thank you so much.</strong></p>
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		<title>Could I suggest that a patient rethink her relationship with a man?</title>
		<link>http://www.managingcontraception.com/newsevents/?p=84</link>
		<comments>http://www.managingcontraception.com/newsevents/?p=84#comments</comments>
		<pubDate>Mon, 03 May 2010 00:56:22 +0000</pubDate>
		<dc:creator>June</dc:creator>
				<category><![CDATA[Dr. Bob Hatcher]]></category>

		<guid isPermaLink="false">http://www.managingcontraception.com/newsevents/?p=84</guid>
		<description><![CDATA[Complete refusal to use a condom would be a strong indication for a young woman or man entering a dating relationship to end the relationship quickly.
If a high school or university counselor is not urging women whose boyfriends refuse to use condoms to rethink that relationship, an important opportunity is being lost. 
]]></description>
			<content:encoded><![CDATA[<p>At the April 14 to 17, 2010 <strong>Contraceptive Technology Update</strong> <strong>conference in Boston</strong> for 670 counselors, nurse practitioners and physicians, the following question came from an employee at the Yale University Health Service.  It could just as easily have come from a counselor or clinician at any college or high school in the country.  Here was the question:<strong><em> </em></strong></p>
<p><strong><em> </em></strong></p>
<p><strong><em>&#8220;Is it professionally appropriate to advise a woman, from a purely medical point of view, to rethink a relationship with a man who will not use condoms at the tender age of 18-21?&#8221;  </em></strong></p>
<p><strong>A:        </strong>In answering this question one may assume that the phrase “the tender age of 18 to 21&#8243; refers to both women and men, since this is a college health service. My opinion is and the consensus of others at the conference was that a clinician or counselor at this health service would definitely be wise to ask a woman to seriously rethink the wisdom of having sex with a guy who would not use<strong> </strong>a condom.  Definitely rethink having sex with that person!<strong>        </strong></p>
<p>Many young men and women enter college having had intercourse with several people and unless there is good reason to believe that both the guy and the gal have never had sex with any other person, the risk of infection should be as important to both of them as the risk of pregnancy. Here are two good reasons why:</p>
<p>First, more than half of the following infections are spread from a person with no symptoms at all:</p>
<p><strong>·</strong>     Chlamydia infections that can lead to infertility.</p>
<p><strong>·</strong><strong> </strong>    Human papilloma virus infections (HPV infections) that can cause cervical cancer.</p>
<p><strong>·</strong><strong>       </strong>Herpes infections that can be very painful and lead to recurrences that last for years and that may necessitate using medications that are very, very expensive.</p>
<p><strong>·</strong>    Human immunodeficiency virus (HIV) infections that eventually lead to AIDS and death.</p>
<p>So a man or a woman with one of the above infections may have zero symptoms suggesting an infection on a given evening– no <strong>red flags</strong> are up saying “we had best use a condom tonight.” </p>
<p><strong>No, the red flag is always up at Yale, at the University of Georgia, at Rabun County High School in northeast Georgia, and at every other high school and college in the land. </strong></p>
<p>Secondly, the risk for the woman, that both of her fallopian tubes will be completely occluded (blocked) goes up with each episode of pelvic infection (infection of the uterus or fallopian tubes). After one infection the risk is about 10%.  After two episodes, the risk is about 25%.  And after three episodes the risk that both tubes will be occluded is about 50%. Many women who are infertile today because of blocked fallopian tubes from infection never knew they had a pelvic infection and had never been treated for an episode of Chlamydia.  Chlamydia definitely can fly under the radar.  Chlamydia is likely to have almost no symptoms at all, but may be doing damage for years without detection.</p>
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<td width="631" valign="top"><strong>Complete refusal to use a condom would be a strong indication for a young woman or man entering a dating relationship to end the relationship quickly.</strong></p>
<p><strong>If a high school or university counselor is not urging women whose boyfriends refuse to use condoms to rethink that relationship, an important opportunity is being lost. </strong></td>
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<p><strong><em> </em></strong></p>
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