The sponge and the IUD

The Today contraceptive sponge

Sponge wary: There is a very pretty 26 y/o with an athletic build who was a patient at the clinic this past weekend. She was in again for Mifeprex. She works in the athletic department at UNLV and is obsessed with young male athletes. She told me her job was like being a taster in a candy store. I thought the comparison was apt since both a steady diet of candy or young men can be fattening. In her case she should have known better since this is her third pregnancy in two years using a sponge for contraception while having sex with student athletes. Go figure! If you are in your late 40s and marginally fertile the sponge may be a good choice, but not when you’re at the peak of your fertility in your twenties and are routinely being filled with semen by lusty young men at the height of their fertility.

The Today sponge is convenient and at about $5 each they aren’t that expensive when you consider that they can be worn for at least 24 hours for as many acts of intercourse as the wearer wants. You just open the packet, moisten the sponge with tap water to activate the N9 spermicide in the sponge and insert the sponge with the concave side facing the cervix. The sponge is left in place for at least 6 hours after the last act of intercourse then pulled out and tossed in the trash. However, I tell all my students in my Contemporary Sexual Health and Advanced Sexual Techniques classes at St Lucy’s that the convenience of the sponge is far outweighed by its lack of effectiveness. It’s not a barrier it’s a spermicide delivery device because there is nothing to hold the sponge over the cervix so it can be easily displaced by a penis large enough to reach it. That’s not to say it shouldn’t be used if that is the only option available.

So anyway, we gave her the Mifeprex and she will return for a follow-up in a few days to make certain she passed all the tissue associated with this pregnancy. I’m trying to talk her into having an IUD inserted so she won’t have to be going through a termination every few months. She said a diaphragm or a FemCap took too much effort to use correctly. She’s not a swimmer so dive-sex doesn’t seem too likely for her so she would be ideal candidate for a ParaGard that can be left in place for more than ten years. She said she would think about it. Her insurance would pay for it so it would be amazingly inexpensive and extremely effective contraceptive solution to her reoccurring problem.

An IUD expulsion: Also on Saturday while I was at the clinic fitting diaphragms for escorts I was between patients and was asked to try to help calm a patient who had come in because she had expelled her IUD during an intense underwater sexual encounter. The drama was because she had been with the husband of the friend - a roommate from med school - she was staying with. She was a Gyn in her early 30s who had come to Vegas to attend a seminar on birth control methods. Go figure! I’m not making this up! Her ParaGard had been inserted two months before in NYC where she practices as a clinical gynecologist. She said she hadn’t been having any trouble with it and that she was fertile and her lover had a very high sperm count (according to his wife) because he had fathered their two children (born 10 months apart) while she was on hormonal contraceptives.

IUD expulsions are fairly common, from 2% to 8% during the first year after insertion, but expulsions are most likely during the first three months after insertion and during menstruation when cramps may expel it. I found her in the exam room with Chuck, our lead male Gyn who knew her from medical conferences they had both attended. I talked to her about having a frameless copper IUD, a GyneFix, inserted. We weren’t supposed to insert a GyneFix in a woman who wasn’t going to be part of the clinical trial, but Chuck agreed to do it as a professional courtesy. The patient wasn’t excited about having a GyneFix until Chuck explained that the new implantation technique that was developed a year ago had decreased the expulsion rate dramatically so the percent of GyneFix devices expelled within a year after implantation using the new technique is less than 2%.

The nice thing about GyneFix is that it is not subject to expulsion from menstrual cramps or from uterine cramps caused by intense sexual encounters. And because it is copper once implanted it has an immediate emergency contraceptive effect so she would be very safe even after the expulsion of her ParaGard. She was given 800 mg of ibuprofen and since she was fertile her cervix was already soft and opens so she didn’t need to be dilated to get the implantation tool through her cervix and up against the fundus where the knot of the thread was buried deep in the muscle. Chuck gave her a ten day regimen of antibiotics to minimize the likelihood of infection while the implantation site healed.

Reflexions as a prophylactic: She was feeling frisky enough after her GyneFix was implanted that she asked to have a diaphragm fitted (she had used one her first few years in med school) so she could continue having sex with her roommate’s husband w/o having to worry about his sperm in her uterus complicating the healing of the implantation site. She said he is really Hot! So I asked if she had a latex allergy and when she said no I fitted her with a 75 mm Reflexions flat spring so it would be very difficult for her ‘hot’ married lover to under-thrust her diaphragm to get semen into her uterus. I also gave her a 100 ml tube of DiveGel+ because her vaginal walls were slightly abraded by the poor lube used during her initial dive-sex encounter. The wife is an ER doctor at a local hospital and as a junior member of the team she gets a lot of 12 hour night shifts leaving her husband available for what ever games her visiting friend wants to play with him.

God knows, I don’t mind a little adultery, as I think it can add spice to a relationship, but that woman was so fixated on her friend’s husband it’s hard to see anything good coming out of it as obsessive as she seems to be. Sometimes we think a guy is hot because he belongs to someone else. I don’t know enough about her to know if that’s what’s driving her lust or if she is just that competitive with all her women friends. Or, if there is real chemistry between her and the guy and he is coming on to her as much as she is encouraging him.

Pointe shoe quiz December 7, 2010

What maker’s shoes is this model wearing?

Black Swan - Opening weekend

Natalie Portman as Nina Sayers/the Swan Queen

The Los Angeles Times
Company Town
The Business behind the Show
December 5, 2010

'Black Swan' has bravura debut in limited release

"Black Swan" has danced away with what may be the best opening weekend of the year for a movie in a limited number of theaters.

Director Darren Aronofsky's psycho-sexual drama about the world of competitive ballet starring Natalie Portman and Mila Kunis took in nearly $1.4 million from 18 theaters in eight cities, according to an estimate from distributor Fox Searchlight.

Its per-theater average of $77,459 is the second highest for any film this year, behind only last weekend's "The King's Speech." But that British drama opened at only four locations, making the debut of "Black Swan" arguably more impressive.

Its strong performance, despite negative reviews from a few prominent publications including the Los Angeles Times, demonstrates that audiences in big cities such as Los Angeles, New York and Chicago have a strong interest in the picture. Searchlight hopes that will continue as the movie expands nationwide over the next several weeks.

"The King's Speech" also continued to play very well, taking in $325,874 at six theaters on its second weekend.

Strong performances for both movies indicate that audiences are excited for the bounty of low-budget films aiming for awards voters' attention coming out at the end of the year.

Ben Fritz

Personal comment: What great news! Now if the film just has legs!

Ballerinas and body image

NYCB - Jenifer Ringer partnered by Jared Angle in George Balanchine's The Nutcracker

The New York Times
December 3, 2010

Judging The Bodies In Ballet
By ALASTAIR MACAULAY

Go to any gallery and you see how painters and sculptors for centuries have made fat an issue. The nudes of Titian, Rubens, Rembrandt and Renoir show women with curves that are no longer part of any fashionable idea of beauty. Venus or Diana had a belly like that? I love most of them myself, but I have friends who object. Either way, all of us acknowledge that weight plays a part in our response.

Which art requires more exposure of the human form than the nude in painting, photography or sculpture? Ballet, of course. Dancers — even when sheathed in tights, tunics, tutus — open their bodies up in the geometrical shapes and academic movements that ballet has codified, and so they make their bodies subject to the most intense scrutiny.

The issue of scrutiny came up this week in a review of “George Balanchine’s The Nutcracker” at New York City Ballet. I wrote that Jenifer Ringer, cast as the Sugar Plum Fairy, “looked as if she’d eaten one sugarplum too many,” and that Jared Angle, as her Cavalier, “seems to have been sampling half the Sweet realm.” (The performance took place the night after Thanksgiving.) This has caused a certain brouhaha online, and a minor deluge of reader e-mails, in many cases obscene and abusive. The general feeling was that my characterizations went beyond the pale of civilized discourse. One reader wrote that the review was “appalling,” “heartbreaking,” “childish, “hurtful” and “incompetent.”

Notably, the fuss has been about Ms. Ringer’s appearance. No one took issue with what might be considered a much more severe criticism, that the two danced “without adult depth or complexity.” And though I was much harder on Mr. Angle’s appearance, scarcely a reader objected. When I described Nilas Martins as “portly” in The New York Times and Mark Morris as “obese” in the Times Literary Supplement, those remarks were also greeted with silence. Fat, apparently, is not so much a feminist issue as a sexist one. Sauce for the goose? Scandal. Sauce for the gander? No problem.

Ballet demands sacrifice in its pursuit of widely accepted ideals of beauty. To several readers that struggle is, regrettably but demonstrably and historically in the case of many women, concomitant with anorexia. (For the record, I have sometimes observed in print that certain dancers of either sex look too thin.)

Ms. Ringer has spoken in the past about coping with eating disorders. Some of my correspondents feel I should know this history of hers, just as others have on occasion written to explain which ballerinas have histories of scoliosis. I think otherwise. Dancers do not ask to be considered victims. When I’ve praised Ms. Ringer, I’ve applied the standards I’ve applied to Suzanne Farrell, Natalia Makarova and Kyra Nichols.

My own history makes me intimately aware of what it is like to have a physique considerably less ideal than any of those I have mentioned. Acute asthma in childhood gave me a chest deformity that often made me miserable into my adolescence. (It was ameliorated by major thoracic surgery at age 20.) On my doctor’s advice, I lost 20 pounds last year.

When a dancer has surplus weight, there can be no more ruthless way to demonstrate it than to dance in a tutu with shoulders bare. Some steps (notably, traveling across the stage on point with arms outstretched) open the upper body to maximum legibility, others the lower. If Ms. Ringer performed flamenco or Bharatanatyam or most forms of contemporary dance, she would look extremely slim. In most of her recent ballet roles, she has actually looked slender.

To be overweight is not to be a bad dancer. Mr. Morris at his largest has often been a sensational performer. I have heard an audience snort with laughter as he arrived onstage and then be awestruck by the brilliance of his dancing.

In the 1970s Lynn Seymour’s weight was more pronounced, and her physique more curvaceous, than Ms. Ringer’s. And her upper arms wobbled considerably more than Ms. Ringer’s did last week. But they were like the wobble on certain notes in Maria Callas’s voice — unfortunate, controversial, but entirely mentionable in an artist who transcended her flaws. Ms. Seymour was one of the greatest ballerinas I ever saw, probably the plumpest and certainly the most original.

Size in ballet is not only a modern obsession. In the mid-18th century at the Paris Opera, the ballerina Marie Allard was dismissed for her inability to lose weight (and the frequency of her pregnancies), while her contemporary Marie-Madeleine Guimard was nicknamed “the skeleton of the graces.” History remembers both, however, as exceptional artists. And it enshrines Marie Taglioni, the archetypal Romantic ballerina of the 19th century. Yet Taglioni as a student was derided by her classmates as a “hunchback.” In due course she became “Marie full of grace” (the echo of the Virgin Mary was intentional), the supreme sylph.

In our own time many other female dancers with obvious physical imperfections have made impressions far greater than those whose bodies were ballet-perfect. But that’s their task: in an Apollonian art that requires purity of line, precision of execution and harmony of appearance, dancers with less than ideal shapes must bring other qualities to bear. Many have, and Ms. Ringer does, too, with several roles. This particular Sugar Plum Fairy — one of her rare tutu parts these days — was not one of them.

Some correspondents have argued that the body in ballet is “irrelevant.” Sorry, but the opposite is true. If you want to make your appearance irrelevant to criticism, do not choose ballet as a career. The body in ballet becomes a subject of the keenest observation and the most intense discussion. I am severe — but ballet, as dancers know, is more so.

Personal comment: I’m blessed with a high metabolism rate and a slim body so I can eat nearly anything I want and since I’m lactating I have to consume an additional 500 calories a day or lose weight. I need to make sure I have foods high in calcium to keep my bones strong and enough iron to offset losses during my periods, but other than that – well I take L-dopa to limit my milk production (an off label use) so I can maintain firm B-cup breasts regardless of how much breast feeding I do. Of course that disappoints thirsty men who find they can easily empty my breasts, but I need to retain my classical figure and B-cup breasts under a compression top is about as busty as I want to get.

In escort training and at St Lucy’s we teach nutritious eating habits and most of the girls are compliant, eating healthy diets. We do have a few who are underweight and won’t listen and those we send for psychological counseling and we suspend them from training as loss of bone mass makes it unsafe for them to dance or participate in very intense sexual encounters, not to mention making them unattractive to men unless they have a concentration camp fetish.

Tina Watson – again

Tina Watson dead on the floor of the Great Barrier Reef in 2003

Questions linger in honeymoon death of Ala. woman
Associated Press Bob Johnson

MONTGOMERY, Ala. – Married for 11 days, Gabe and Tina Watson strapped on their scuba dive equipment for a chance to explore a 100-year-old shipwreck in the natural underwater wonder that is Australia's Great Barrier Reef.

The Alabama couple splashed into the water on their 2003 honeymoon halfway around the world, and the dive soon turned horrific — 26-year-old Tina Watson's lifeless body began drifting toward the ocean floor. Was it a tragic accident, as her husband claimed? Or did Gabe Watson deliberately disconnect her air supply, then hold her in a bear hug, drowning his new wife, as Alabama authorities contend?

Gabe Watson, dubbed the "Honeymoon Killer" by Australian media, pleaded guilty to manslaughter there for not doing enough to save his wife. Now, the case is back in the United States. Alabama prosecutors believe his 18-month prison stint was too lenient, and they think they can get a murder conviction on home soil.

The case is ripe with international legal issues, but legal experts say there's no reason Gabe Watson can't be tried again for the same crime in the U.S., in part because prosecutors allege he concocted a plot to kill his wife in Alabama, supposedly for a life insurance payout. Defense attorneys say there was never such a plan or policy, and they want the case dismissed.

Gabe and Tina Watson met while both were attending classes at University of Alabama at Birmingham, a sprawling urban campus in downtown Birmingham, not far from their homes. They started dating in 2002 after she broke up with a boyfriend. Her father, Tommy Thomas, recalled how she told her parents about meeting a "very nice man" in her classes, a man who was "funny and a little weird."

Gabe and Tina became engaged around Easter 2003 and were married Oct. 11. They jetted off to Australia, and Thomas said his daughter was excited about the trip. She had always wanted to visit the famous Sydney Opera House.

Watson initially wanted to start the honeymoon with the diving trip, Thomas said, but Tina talked him into going to Sydney first.

She was, Thomas said, "a beautiful girl."

"One of the divers on the dive boat said she was 'Miss Alabama beautiful, both inside and out,'" he said. "She would walk into a room and everybody in the room would start smiling and laughing."

His daughter had a passion for animals, liked to shop and loved romantic movies — her favorite was "Gone With The Wind."

The couple had graduated from UAB before their marriage, and he was working in his father's packaging business. She was working for a Birmingham area department store. Their lives were ahead of them.

Now Gabe Watson, indicted by an Alabama county grand jury on a capital murder charge, is in custody in Los Angeles. He is expected to return to his home state in the next several days to face new charges.

His attorneys said they will likely ask to dismiss the case on grounds of "double jeopardy," which prevents a defendant from being tried twice on similar charges.

But Bruce Zagaris, an international law expert in Washington, D.C., said the U.S. position in such cases has been that "unless the extradition treaty prohibits double jeopardy, then the U.S. can try the person again."

The treaty doesn't mention double jeopardy. Australia did hesitate to send Gabe Watson back, though, fearing he might face a possible death sentence. Australia does not have a death penalty and its leaders have been outspoken opponents to capital punishment.

Alabama Attorney General Troy King and federal authorities agreed he would not face the death penalty, though a conviction could carry a life term in prison.

Prosecutors want to know why Watson swam to get help instead of attempting to rescue his wife. Assistant Attorney General Don Valeska has described Watson as an experienced rescue diver who should have known not to leave his "dive buddy." Tina Watson was making one of her first dives in open water.

Watson's attorney, Brett Bloomston, said his client took a rescue course at a lake outside Birmingham, but did not have experience with open water rescues, particularly in a location like the Great Barrier Reef, with swift currents.

Watson initially was charged with murder in Australia, but after a lengthy investigation, pleaded guilty to the lesser charge.

One of the reasons for the plea was the uncertainty over exactly what happened as the couple began the fateful dive to the wreck of the SS Yongala, a passenger and steam freighter that sank during a storm in 1911 near the northeast Australia city of Townsville.

At a 19-day coroner's inquest in Australia, Watson said in a videotaped police interview that his wife began having trouble a few minutes into the dive and panicked. He said she clutched at his mask and pulled it off, and by the time he put it back on, she was sinking, arms outstretched toward him.

Gabe Watson swam away and one of the dive leaders pulled Tina Watson to the surface, but she could not be revived. Tests found nothing wrong with her diving gear, and an autopsy found no pre-existing medical condition. At the inquest, a fellow diver said he saw Watson engaged in an underwater "bear hug" with his petite wife.

Australian authorities said Gabe Watson also gave conflicting accounts, including that a strong current may have been a factor.

Valeska, the Alabama prosecutor, said much of their case will come from evidence gathered in Australia. He expects to bring investigators and other witnesses from Australia, and for the most part, Alabama officials have not conducted a separate probe.

Gabe Watson's attorney has also said there never was a life insurance policy that would have benefited his client. He said a $33,000 insurance payment was made to Tina Watson's father, not her husband.

"The Australians never could prove murder," Bloomston said.

But Thomas said his daughter told him shortly before the marriage that Watson wanted her to change the life insurance policy, a group policy she got at the department store where she worked. Thomas said she told him Watson wanted her to increase the amount of the policy and change the beneficiary to Watson, not her father.

He said he gave his daughter some advice.

"I told her to tell him it had been taken care of and when you come back from Australia take care of it then," Watson said.

Personal Comment: Did he really shut off her air in sight of other divers? Or, did he freak out and run when she got in trouble and he had the chance to save her? It will be interesting to see if he can be tried in the U.S. for his wife’s murder. From what I’ve read of the case I think he got off too easy the first time.

Leigha, You once said something to the effect that there was a good bit more to the story of Gabe and Tina Watson that didn’t get in the papers. Now that he is no longer in custody in Australia is there anything more you can tell us?

Black Swan - the NYT review

Natalie Portman as Nina Sayers/the Swan Queen

The New York Times
December 2, 2010
Movie Review 'Black Swan'

On Point, on Top, in Pain
By MANOHLA DARGIS

A witchy brew of madness and cunning, “Black Swan” tells the story of a ballerina who aches, with battered feet and an increasingly crowded head, to break out of the corps. Played by Natalie Portman in a smashing, bruising, wholly committed performance, the young dancer, Nina, looks more like a child than a woman, her flesh as undernourished as her mind. When she goes to bed at night, a nearby jewelry box tinkling “Swan Lake,”a crowd of stuffed animals watches over her, longtime companions that — as Nina and this dementedly entertaining film grow more unhinged — begin to look more like jailers than friends.

Crammed with twins — lookalikes, mirrored images, doppelgängers — the story follows that of the “Swan Lake” ballet in broad, gradually warped strokes. It opens with the artistic director of a fictional New York ballet company, Thomas (Vincent Cassel), announcing that the new season will begin with a “visceral and real” version of that old favorite. To that end he dumps his prima ballerina, Beth (Winona Ryder), and picks Nina to dance the dual role of the swan queen (an enchanted woman in bird form) and her villainous black twin. But as the pressure builds, things fall apart, or Nina does. She stumbles out of a spin and begins scratching at her skin. One day she strips a piece from her finger as lightly as if she were peeling a banana.

Part tortured-artist drama, “Black Swan” looks like a tony art-house entertainment. (Hey, there’s Lincoln Center!) But what gives it a jolt is its giddy, sometimes sleazy exploitation-cinema savvy. The director Darren Aronofsky is a well-schooled cinéaste, and in “Black Swan” he riffs on Michael Powell and Emeric Pressburger’s ballet masterpiece, “The Red Shoes,” and the pair’s “Black Narcissus,” among other influences. But it’s also likely that Mr. Aronofsky, who was born in 1969 and grew up in Brooklyn, frequented Times Square when it was known as the deuce and lined with movie palaces playing the best and worst in trash cinema. I bet he also caught a few episodes of the “Red Shoe Diaries” on cable.

That isn’t a knock. One of the pleasures of “Black Swan” is its lack of reverence toward the rarefied world of ballet, which to outsiders can look as lively as a crypt. Mr. Aronofsky makes this world (or his version of it) exciting partly by pulling back the velvet curtains and showing you the sacrifices and crushingly hard work that goes into creating beautiful dances. Nina doesn’t just pirouette prettily, she also cracks her damaged toes (the sound design picking up every crackle and crunch) and sticks her fingers down her throat to vomit up her food. Mostly, though, she trains hard, hammering her toe shoes into floor much as Jake La Motta pounded his fists into flesh. She’s a contender, but also a martyr to her art.

Mr. Aronofsky is happy to see her bleed. A filmmaker who likes to play around with genre while mixing the highbrow with the lowdown and dirty, he has built a small, vivid catalog by exploring human extremes with wildly uneven degrees of visual wow, sensitivity and intelligence. He trawled the lower depths in “Requiem for a Dream” and struggled to scale the metaphysical heights with “The Fountain,” a fable about eternal (as in, when will it end?) love. For his previous movie, “The Wrestler,” he proved his commercial smarts by taking Mickey Rourke out of deep freeze and dusting off a comeback story that was old when Wallace Beery wiped Jackie Cooper’s runny nose with the script for “The Champ.”

“Black Swan,” by contrast, surprises despite its lusty or rather sluttish predilection for clichés, which include the requisitely demanding impresario (Mr. Cassel makes a model cock of the walk) and Nina’s ballerina rival, Lily (Mila Kunis, as a succulent, borderline rancid peach). But, oh, what Mr. Aronofsky does with those clichés, which he embraces, exploits and, by a squeak, finally transcends.

Such is his faith in his ability to surmount the obvious (and the lethally blunt) that he turns Nina’s mother, Erica (a terrific Barbara Hershey), into a smother-mother who out-crazies Faye Dunaway’s Joan Crawford in the mommy dearest department. You don’t know whether to laugh or shriek (both are reasonable responses), and it is this uncertainty and at times delicious unease that proves to be Mr. Aronofsky’s sweet spot.

It’s easy to read “Black Swan” as a gloss on the artistic pursuit of the ideal. But take another look, and you see that Mr. Aronofsky is simultaneously telling that story straight, playing with the suffering-artist stereotype and having his nasty way with Nina, burdening her with trippy psychodrama and letting her run wild in a sexcapade that will soon be in heavy rotation on the Web. The screenplay, by Mark Heyman, Andrés Heinz and John McLaughlin, invites pop-psychological interpretations about women who self-mutilate while striving for their perfect selves, a description that seems to fit Nina. But such a reading only flattens a film that from scene to scene is deadly serious, downright goofy and by turns shocking, funny and touching.

With “Black Swan” Mr. Aronofsky has found a surprisingly accommodating vehicle for his preoccupations, including bodies in pain, and his ever more refined technique. Here, working with his usual cinematographer, Matthew Libatique, and largely shooting hand-held in both super-16-millimeter film and digital, Mr. Aronofsky opts for grit over gloss, an ideal strategy for a story with a harsh underbelly. Hand-held cinematography can be lazy shorthand for “reality” (as if life happens in shaky-cam), but here the hand-held visuals work because of their intimacy. The influence of the Belgian filmmakers Jean-Pierre and Luc Dardenne can be seen in the close, tag-along shots of Nina’s head as she hurries off, a point of view that brings you within breathing, at times panting, distance of a character whose behavior can be off-putting.

Though it had its moments, “The Wrestler” felt like the work of a director who, after proving his street bona fides and bombing at the box office, decided to try some pandering. It worked: Mr. Rourke was rediscovered, and Mr. Aronofsky’s future was salvaged, in part because he had closed the distance between the fallen star played by Mr. Rourke and the one he himself had become. Ms. Portman’s performance in “Black Swan” is more art than autobiography, and as a consequence more honest, but because it’s so demandingly physical the lines that usually divide actresses from their characters are also blurred. This is, after all, Ms. Portman’s own thin body on display, her jutting chest bones as sharply defined as a picket fence.

Although Mr. Aronofsky focuses on her head, shoulders and arms, mostly avoiding long shots that might betray a lack of technique, Ms. Portman does most of her own dancing (and plausibly, at least to this ballet naïf). The vision of Ms. Portman’s own body straining with so much tremulous, tremendous effort, her pale arms fluttering in desperation, grounds the story in the real, as do the totemic Lincoln Center buildings, the clattering subway and the grubby, claustrophobic apartment Nina shares with her mother. Together they create the solid foundation of truth that makes the slow-creeping hallucinatory flights of fantasy all the more jolting and powerful. Much like the new version of “Swan Lake” that Thomas creates, “Black Swan” is visceral and real even while it’s one delirious, phantasmagoric freakout.

“Black Swan” is rated R (Under 17 requires accompanying parent or adult guardian). Bedroom gymnastics and graphic violence.

BLACK SWAN

Opens on Friday in New York and Los Angeles.

Directed by Darren Aronofsky; written by Mark Heyman, Andrés Heinz and John McLaughlin, based on a story by Mr. Heinz; director of photography, Matthew Libatique; edited by Andrew Weisblum; music by Clint Mansell; ballet choreography by Benjamin Millepied; production design by Thérèse DePrez; costumes by Amy Westcott, ballet costumes by Kate and Laura Mulleavy of Rodarte; produced by Mike Medavoy, Arnold W. Messer, Brian Oliver and Scott Franklin; released by Fox Searchlight Pictures. Running time: 1 hour 50 minutes.

WITH: Natalie Portman (Nina Sayers/the Swan Queen), Vincent Cassel (Thomas Leroy/the Gentleman), Mila Kunis (Lily/the Black Swan), Barbara Hershey (Erica Sayers/the Queen) and Winona Ryder (Beth Macintyre/the Dying Swan).

Personal Comment: I’m so pleased that the NYT critic liked the film! Not that a critical success necessarily translates into a box office success. It has to be liked by the ticket buying public but that a film and dance critic for the Times thought it was great really helps. Sarah Lane, a Soloist for American Ballet theater, is the body double for Natalie during dance scenes where ballet technique mattered.

Sarah Lane ABT Soloist and Portman’s body double

Vaginal health

Premarin vaginal estrogen cream

Vaginal Health: Thanksgiving weekend I had nine men as guests along with the women they were escorting, they were: Chris, Robin, Jeff, Pirate, Peter, Colin, Clark, Adolph and Jon. The tenth is Jacques, Gigi’s father, and my main squeeze and live-in lover. With the exception of Colin, who Fiona (Cyndi’s Mom) tried to put off limits (except to me) the other men; including Jacques were shared for the weekend so every woman got to bed every man at least twice. Well, that was the plan. Since most of the women, other than me, have GyneFix IUDs implanted pregnancy wasn’t really a concern. I could sense Fiona was afraid I would take Colin away from her, or be so much better in bed that he would begin comparing her to what he got from me. I don’t think so. Jacques is an excellent judge of a woman’s sexual abilities and had bedded Fiona before. He says “she is a very good lay, tight, deep, wet and very exciting with a marvelous scent” were his exact words. Colin is fun and a good lover with a better than average package and technique, but as a Brit he is a bit too reserved for me and I’m not in the mood to collect British SAS officers right now either. So Fiona is quite safe in that regard (aside from my using him temporarily to fill me with sperm) but she was still edgy when he was around me.

I understand her not wanting to share Colin, but it was only for the holiday and it wasn’t like she had taken a vow of chastity herself. We were all draining semen the entire weekend and this morning as well. Even with SET – semen emitting technique – using Kegels and tissues to squeeze most of the semen out - we still drained into our thongs. I left packs of party thongs for the girls in each of their rooms and in the bathrooms in the formal area so they could change as necessary and toss the old ones.

Everyone had a recent full STI panel so there was no concern there, but by taking that many different men bareback - which is how we all wanted them - in such a short interval there is always a chance of unbalancing the vaginal flora and ending up with a yeast infection or bacterial vaginosis. Neither of those are STIs (like Chlamydia, Herpes or gonorrhea are) but still they are uncomfortable and can be frustrating to treat. So I took Jeff up on an offer he had made several months ago to add an experimental biocide to Dive-Gel. He wanted us to trial it and he’s calling it DiveGel+.

DiveGel+: The biocide has been in clinical trial as Gel-33 in Thai brothels. They were hoping for a reduction in the transmission of the HIV virus, but that hasn’t materialized. What the results did show is the cases of YIs and BV dropped to nearly zero. So Jeff added 4% of the experimental biocide to Dive-Gel as the application medium and packaged it in a case of 48 100 ml tubes and is calling it DiveGel+. We all used DG+ as a lube for the long weekend and it will be interesting to see if anyone comes down with a YI or BV.

As part of getting Jeff to provide us the DG+ I agreed to have our clinic enroll the female escort trainees, my circle of friends, my ballet company and the ballet classes and swim teams at St Lucy’s as participants in the clinical trial so he can get some data closer to home. That way he is also covered in providing an experimental drug to a limited number of local women. The clinic had already been talking about wanting to participate in a clinical trial of a biocide so I didn’t have any problem getting them to agree to sign on with Jeff’s DiveGel+ formulation as they were already using and recommending Dive-Gel to their professional patients.

Premarin and well hung men: Shortly after Fiona arrived last Tuesday, while I was telling her about the men we would be sampling over the holiday weekend she confided that her vaginal tissues weren’t as stretchy as they once were. At 44 she’s not that much older than I am and she uses her well preserved body in her work, just not as blatantly as I do, so I thought she would have had any vaginal atrophy already being treated, but she said that the congressmen, senators and lobbyists she works with weren’t super-sized as far as their packages were concerned so she had been putting it off. She only realized she had a problem because her largest dildo that she had been fond of using was becoming painful to insert, not from lack of her natural lube but because her tissues weren’t as stretchy as they were a few years ago.

At 39 I knew exactly what she meant and when I found myself getting that way two years ago I started a regimen of the topical estrogen Premarin, a finger full to coat the external vaginal tissues around the introitus that are subject to tearing with penetration by a very large diameter man or one who corkscrews as he buries his shaft which can sometimes catch a fold of labial tissue if I’m not fully aroused when he enters me. I use the .025 mg/gram strength which is the lowest dose and is enough to make me super stretchy w/o noticeable estrogenic side effects. I had Chuck our male Gyn write her an Rx and give her a tube of .025 mg Premarin and told her she might want to hold off taking Peter, Clark and Jon until Saturday as they were spectacularly hung as far as diameter (the critical dimension) is concerned to give the estrogen cream at least three days to work it’s magic. I’m pleased to say she was able to easily handle Jon the largest and the one with the most corkscrew thrust. She confided afterward that after using the Premarin for three days she felt as though she was twenty-five again.

Cyndi and Peter: Cyndi especially enjoyed taking Peter (as a change from Chris) so the weekend was special for her in that way. I think it’s not only because his package is so large and he uses it so well, but because Peter has impregnated so many women who thought they were quite safe using an effective method of birth control only to find a few days after sleeping with Peter that they tested positive for hCG. He seems to be especially good about fertilizing the eggs of girls on hormones who have either forgotten to take a pill, change a patch or insert a new ring. Taking meds that reduce the levels of hormones in the bloodstream leading to breakthrough ovulation is another way Peter’s pregnancies (as they are called) occur. He has a really high sperm count so every time he plants his seed in a woman’s belly she has to wonder, regardless of how good her contraceptive protection is. Actually Peter is in demand by women for that very reason; his groupies love the unknown waiting breathlessly for the results of their pregnancy tests after having an encounter with him to find out if they need to take Mifeprex.