Tuesday, May 31, 2011

FDA alert concerning COCs and Drospirenone


Birth control pills containing the progestin Drospirenone

Tuesday, May 31, 2011 3:34 PM
From: "FDA MedWatch" fda@service.govdelivery.com

Food and Drug Administration MedWatch
FDA Safety Information and Adverse Events Reporting Program


Birth Control Pills Containing Drospirenone: Possible Increased Risk of Blood Clots

AUDIENCE:
OBGYN, Family Practice, Patient

ISSUE: FDA is aware of two newly published studies that evaluated the risk of venous thromboembolism (VTE) in women who use birth control pills that contain drospirenone. The two recently published studies looked at whether there is a higher risk of blood clots in women taking birth control pills containing the progestin drospirenone when compared to similar women taking birth control pills containing a different progestin called levonorgestrel. These two new studies reported that there is a greater risk of VTE associated with birth control pills that contain drospirenone. This risk is reported to be up to 2 to 3 times greater than the risk of VTE associated with using levonorgestrel-containing pills. Other studies have not reported an increase in risk. The FDA is currently evaluating the conflicting results from these studies and will look at all currently available information to fully assess the risks and benefits of drospirenone-containing birth control pills. FDA will continue to communicate any new safety information to the public as it becomes available. Read the drug safety communication for more information on these studies.


BACKGROUND: Drospirenone is a type of female sex hormone called a progestin. Most birth control pills contain two types of hormones--estrogen and progestin. Birth control pills work by preventing the release of eggs from the ovaries (ovulation) and changing the cervical mucus and the lining of the uterus to prevent pregnancy. Brand names of drospirenone-containing products include Yaz (generics Gianvi and Loryna), Yasmin (generics Ocella, Syeda, and Zarah), Beyaz, and Safyral.


RECOMMENDATION: If your birth control pill contains drospirenone, do not stop taking it without first talking to your healthcare professional. Contact your healthcare professional immediately if you develop any symptoms of blood clots, including persistent leg pain, severe chest pain, or sudden shortness of breath. If you smoke and are over 35 years of age, you should not take combination oral contraceptives because they increase the risk that you could experience serious cardiovascular events, including blood clots.

Healthcare professionals and patients are encouraged to report adverse events or side effects related to the use of these products to the FDA's MedWatch Safety Information and Adverse Event Reporting Program:

• Complete and submit the report Online: www.fda.gov/MedWatch/report.htm
• Download form or call 1-800-332-1088 to request a reporting form, then complete and return to the address on the pre-addressed form, or submit by fax to 1-800-FDA-0178

Read the MedWatch safety alert, including a link to the Drug Safety Communication and Questions and Answers, at: http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm257337.htm

Personal comment: It’s been known for some time that there may be an increase in serious side effects of combined oral contraceptives (COCs) containing Drospirenone. The risk, if proven, is still slight for young women who are not overweight and don’t smoke. St Lucy’s girls taking pills containing Drospirenone have all been counseled by the school’s reproductive health staff and most plan to stay on their current pill. No St Lucy’s students have had serious side effects while on pills containing Drospirenone.

Wednesday, May 25, 2011

Beavertail seduction

Lesbian escort candidates training in beavertails

The beavertail seduction jacket: The beavertail jacket is easy to get in and out of and is ideal as a dive-sex tease. In lighter moments, as a tension release, I teach ‘Beavertail Seduction’ in my Advanced Sexual Techniques class at St Lucy’s and it is a popular facet of the course. Modern copies of the vintage beavertail jacket complete with brass twist-latch crotch fasteners and wrist zippers are available in the new neoprene materials that allow more flexibility in a form fitting jacket so a girl can show off her legs while by opening the front zipper midway she can display her breasts appearing to be available while at the same time seemingly protected from the male gaze. The beavertail-girl and her admirers all knowing that in seconds with one pull on the zipper and opening two twist-latches the delights of her ripe body can be made fully accessible for a sexual encounter. The self lubricating zipper pulls and precision detent twist-latches make Gepettos faux-vintage line of beavertail jackets a must-have in any sexually active female diver’s wardrobe. Another nice thing about the beavertail jacket is that the 5 mm neoprene back protects the wearer if a rented tank harness still isn’t comfortable after adjustment or if she is pushed into and penetrated against a wall while on the surface in a training facility which often happens during training at Adolph’s.

Hoods with beavertails: I’ve mentioned the utility of hoods before, but it doesn’t hurt to mention it again because we see young divers with large sections of their long hair cut away because they couldn’t get it untangled from their dive gear after they wore it loose while on a dive. It’s undeniable that long hair floating around a divers face or streaming behind her when she is moving can be gorgeous, but entangled in hoses, valves and regulators it can limit the range of movement of a woman’s head and sometimes impair the functioning of her equipment. Hoods are ideal for controlling and protecting a diver’s long hair while also providing thermal protection and keep her hair from being used as a weapon against her in a fight. I prefer wearing a hood for an additional reason. I think it adds an element of mystery about me showing the shape of my head while hiding the color and style of my hair and a hood provides an element of anonymity concealing my long auburn hair when I’m trying to go unnoticed.

Our ‘Rapture’ celebration: The get-together at Adolph’s Saturday afternoon (5/21) with a small group of friends was to celebrate the passing of yet another end-of-the-world pronouncement with no apparent effect. Was Harold Camping's ‘prediction’ a scam to suck millions from the credulous, or does he just need a new calculator? This is the second time he has missed his own prediction of an EOW date. But wait! He’s trying again! He has revised his apocalyptic prophecy, saying he was off by five months and the Earth actually will be obliterated on Oct. 21. Go figure! Will the third time be the charm? Will he scam millions more from true believers? I think we have far more to worry about from religious extremists with WMDs.

In any case, we had a great time though Diané was far more sensitive to nitrogen narcosis than any of the rest of us and couldn’t go below 100 feet w/o flooding her mask. Peter stayed with her and they had their own more or less private encounter at 80 feet while the rest of us were enjoying the buzz of nitrogen intoxication at depths between 125 and 150 feet. All the guys behaved themselves, I mean by not pulling their partner’s gas guard out, which I was a bit concerned about since some of the guys think that sort of thing is extremely funny because it leaves the girl vulnerable. Afterward Adolph had a lovely buffet of pulled pork barbecue, smoked salmon, prawns, raw oysters, caviar on toast points, and raw veggies. I thought it was pretty much a male menu, heavy on the protein, but not the usual German dishes he serves so that was a welcome change.

Big Pharma and dive-sex: Pharmaceutical representatives for the major drug houses like Pfizer, Barr, Watson, Johnson & Johnson, Bayer-Schering, Ortho McNeil-Jansen etc routinely meet with the Gyns and Nurse Practitioners at our clinic to educate the practitioners about their contraceptive products. The Pharma Reps are all young, attractive, athletic well educated women who can get and hold the attention of the (mostly male) medical professionals who are their clients. One of the Reps who I have recently become friends with works for Pfizer and until recently she pretty much ignored me. She was courteous enough, but her attention was directed toward the Gyns and PAs who prescribe contraceptives. However, after a friend with an IUD got PID and ended up with a badly scarred fallopian tube from having pool water forced into her uterus during dive-sex Ms Pfizer sought me out. She wanted to be fitted with a professional level diaphragm to use as a gas-guard during dive sex. She had heard from friends in a professional woman’s group she is in that I am the go-to girl for dive-sex protection and training.

It’s nice to be appreciated, but that’s not quite accurate because I don’t train clients who walk in off the street. I have quite enough to do working with the Casino’s escort trainees and with students in my St. Lucy’s Contemporary Sexual Health and Advanced Sexual Techniques classes which are in addition to my being AD for the casino’s ballet company. But she provided an opportunity for me to become valuable to a major Pharma Rep who has the authority to dispense samples of all sorts of meds at her own discretion. My new BFF, Ms Pfizer, is taking a Pfizer contraceptive, the continuous COC Lybrel that is taken 365 days a year (13 packs) so in theory she has no periods in a year. However, in real life that isn’t quite the way Lybrel works for many (about 60%) of the women who take it. A Lybrel blister pack contains twenty-eight (28) yellow tablets each containing 90 mcg of levonorgestrel, and 20 mcg of ethinyl estradiol and after taking Lybrel for about two years she is still experiencing occasional instances of spotting. But because her pill-periods were so painful with other pills she tried she thinks the occasional unexpected spotting is worth the bother. So she has been using an All-Flex diaphragm, inserting it daily, to prevent any possibility of embarrassing bleed-through instances when spotting.

The invitation: She has been invited for an all expenses paid weekend at The Lorelei by Adolph (he is inviting all the Pharma Reps one at a time) and she said she wanted me to give her at an overview of what to expect during dive-sex, but she really wanted more. She had heard she needed to wear a gas-guard during dive-sex and thought that her All-Flex would serve that purpose. However, she recently had an instance with a lover where he managed to under-thrust the rim of her All-Flex and left his seed in the dome. She wasn’t concerned about pregnancy, but was worried, and rightly so, that if her All-Flex was under-thrust during dive-sex she could be at risk of PID or an embolism. So she sought me out to be fitted for the style gas-guard a professional escort uses for dive sex, Reflexions, and to discuss the possibility of it being under-thrust. Additionally, she wanted to know what to expect from Adolph because she had heard I know him well.

The good news: She is not allergic to latex, has a wide pelvic ledge and a 70 mm Reflexions fits her perfectly. She is also PADI qualified for open water so at least she knows how to use her SCUBA equipment which was a big help when we went into the training pool first to practice underwater insertion with a G-spot dildo and then a bit later a male escort candidate joined us (he needed the practice) to give her her first heterosexual dive-sex encounter. I reassured her that while it is possible for a determined man to under-thrust the rim of a Reflexions it is very unlikely because it hurts the man to under-thrust a flat spring rim and it is unpleasant for the woman as well so she would know if the attempt was made. I also coached her to pay close attention to the amount of air she has left because during underwater sex you tend to forget about breath control and gas conservation. Running out of air during an encounter really ruins the mood and makes a man like Adolph very angry.

I told her he has a habit of preventing a partner who runs out of air from starting for the surface until he plants his seed inside her so that delay can be very unpleasant and sometimes extremely dangerous. While things are going his way he has the appearance of amiability. However when something goes wrong he has a very quick and violent temper, so when she is depending on him for her safety I said she should do whatever is necessary to please him. My advice initially took some of the enthusiasm out of her anticipation of the weekend, but she is determined to do whatever it takes to meet Adolph’s expectations – if it gets her a free weekend at The Lorelei – because she has heard how luxurious the spa is. She promised to let me know how her weekend at The Lorelei goes.

Monday, May 23, 2011

Saturday, May 21, 2011

A Rapture party


‘Rapture of the deep’ by Sue Dawe

A ‘Rapture’ party: To celebrate the end of the world, which is supposed to occur here in Las Vegas at 6:00 PM PDT today, at that very hour I’m co-hosting a ‘rapture’ party at Adolph’s. We will be diving regular gas (21% oxygen) down to a depth of 150 feet in his training facility (there is a net across the pool at that depth to prevent anyone from going deeper) to enjoy the effects of nitrogen narcosis during dive-sex encounters. We will have five Dive-masters who will be breathing Trimix to watch out for those of us who may get too narced and start behaving dangerously and to make sure we all deco properly on the ascent.

Couples invited to enjoy the rapture are: 1) Cyndi & Chris, 2) Anya & Robin, 3) Shelly & Jeff, 4) Marie-Claude & Pirate, 5) Diané & Peter, 6) Adolph and Elke, 7) Gigi and Jon, 8) Aimée and Doug and 9) Jacques & me. This will be the first time the teens; Cyndi, Gigi and Aimée will be intentionally exposed to the effects of nitrogen narcosis (NN) which is somewhat similar to nitrous oxide in relieving anxiety and providing a feeling of wellbeing, but NN can affect the same diver differently on different dives so its hard to tell how they will do – they could freak out – when they get intentionally narced. Most of the women have GyneFix IUDs implanted (all except me and I have an Oves sucking on my cervix) so pregnancy from having our partners plant their seed deep inside us isn’t a concern as much as if some of the guys will lose touch with reality enough to intentionally pull out some of our gas-guards. The article about nitrogen narcosis on Wikipedia says this about the symptoms: “The most dangerous aspects of narcosis are the loss of decision-making ability and focus, and impaired judgment, multi-tasking and coordination. Other effects include vertigo, and visual or auditory disturbances. The syndrome may cause exhilaration, giddiness, extreme anxiety, depression, or paranoia, depending on the individual diver and the diver's medical or personal history. When more serious, the diver may feel overconfident, disregarding normal safe diving practices.”

This should be an amazing party!

More Strauss-Kahn fallout

Hotel housekeeping staff at work

The New York Times
May 20, 2011
By STEVEN GREENHOUSE

Sexual Affronts a Known Hotel Hazard

A lot of people were shocked by the charges that the head of the International Monetary Fund sexually assaulted a hotel housekeeper in New York last weekend.

But housekeepers and hotel security experts say that housekeepers have long had to deal with various sexual affronts from male guests, including explicit comments, groping, guests who expose themselves and even attempted rape.

“These problems happen with some regularity,” said Anthony Roman, chief executive of Roman & Associates, a Long Island company that advises hotels on security matters. “They’re not rare, but they’re not common either.”

Hotels are reluctant to discuss such incidents, but security experts say the accusations against Dominique Strauss-Kahn, the I.M.F. chief, will prompt some hotel managers to review their security practices to better protect their housekeeping staff.

Zemina Cuturic, a refugee from Bosnia who works at the Tremont Chicago Hotel, said she remained frightened whenever she had to clean Room 410 because of what happened there a year ago. She was vacuuming, she said, and the guest, who had left the room minutes earlier, suddenly reappeared and “reached to try to kiss me behind my ear.”

“I dropped my vacuum, and then he grabbed my body at the waist, and he was holding me close,” Ms. Cuturic recalled. She persuaded the guest to let her go, and she fled. “It was very scary,” she said. Ms. Cuturic reported the incident to hotel management, but decided against going to the police. “I was kind of scared that he’d come back the next day if I did,” she said.

A Tremont official said the hotel, part of the Starwood chain, has a full-time security guard whose only job is to watch over the housekeeping staff. In the incident that Ms. Cuturic described, the official said that management confronted the man and insisted that he leave the hotel.

Housekeepers, nearly all of whom are women, talk of guests who offer them $100 or $200 for sex, apparently thinking that the maids, often low-paid immigrants, are desperate to earn more money. Some women complain of episodes in which they were bending over to, say, clean a bathtub, and a guest sneaked up and stuck his hand up their skirt.

Tom Whitlatch, president of Risk Services, a security consulting firm, said many hotel companies were taking a new look at safety after the accusations against Mr. Strauss-Kahn, who has resigned from the I.M.F. to focus on fighting the charges against him.

“I can assure you that the big hotel chains are aware of this incident and are saying, ‘We need to make sure our housekeepers are trained about this and we’re doing enough to prevent things like this from happening,’ ” he said.

Mr. Whitlatch said that there was little that hotels could do to prevent some of the incidents, but that training and good security procedures could reduce the risks to housekeepers.

Kathryn Carrington, a retired housekeeper who worked 30 years at the Grand Hyatt in Manhattan, recalled several occasions when she went into a room to clean, only to have a male guest emerge from the shower in his bathrobe, which then suddenly opened.

In one case, she said, a guest propositioned her, saying, “I see a pretty dark girl. Can you do something for me?” Ms. Carrington acknowledged that she used to carry a can opener with her in case she ever needed to defend herself from a guest.

The Grand Hyatt’s management was very supportive, she said. “They’d tell you, ‘If any situation occurred, get to the nearest phone and call the supervisor and leave the room. Someone else will help you do the room,’ ” she said.

The Hyatt Corporation declined an interview request, but said in a statement, “The safety and security of guests and associates is one of our top concerns.” It noted that its hotels employed many security measures and safety protocols. “Any time an associate raises a concern, we take it very seriously, promptly investigate the situation and follow as appropriate,” the company said.

Andria Babbington, a union safety official and a former room attendant at a major Toronto hotel, said at least five guests exposed themselves to her during her 17 years in housekeeping. She remembers once having to deliver a bathrobe to a guest who had called for one. “I knocked on the door. He said, ‘Come in,’ and I saw the guest had no clothes on,” she said. “He asked whether I could touch a certain part of his body.”

Some safety experts recommend that hotels send a male employee to deliver bathrobes or blankets when guests call for them, although they say that even male hotel workers are occasionally grabbed or propositioned by female guests.

There is also debate about whether an open or closed door is safer for a housekeeper cleaning a room.

Mr. Whitlatch recommends that housekeepers keep the door closed, saying that makes it harder for an outsider to enter to attack them or to steal the guest’s belongings. If the guest enters with a key, he said, the housekeeper should return later to finish the room.

But some maids disagreed, saying an open door can discourage a guest from misbehaving because another guest might be walking by outside.

“Keeping it wide open is the best option,” Ms. Babbington said. “When the door is shut, no one knows you’re inside.”

Ms. Carrington, the retired Grand Hyatt housekeeper, said the smartest approach was to keep the door open with the cart wedged in the doorway. “If someone comes into the room, they have to move the cart, and you hear it,” she said.

The Embassy Suites hotel in Irvine, Calif., mandates closed doors during cleaning — a policy that bothers Argelia Rico, a housekeeper there. She recalled an incident in 2009 when she was cleaning a bathroom and the guest walked in. “He asked me to change the sheets, and he went to the living room,” she said. “I was bending over tucking in the sheets, and suddenly he had come up right behind me. He was naked.”

She said the man lay down on the bed, aroused, and asked her to leave. “I was very scared because he could have just locked the door and raped me,” she said.

Christopher Daly, a spokesman for HEI Hotels & Resorts, which manages the hotel in Irvine, said it had no record of such an incident. “If any such activity, including sexual assault, was brought to our attention, we at the hotel would contact authorities ourselves, whether or not the employee asked us to or was planning to file charges,” he said.

Guests are not the only threat to housekeepers. Police in the Washington area suspect that a still-unidentified attacker raped seven housekeepers in a series of incidents several years ago.

Housekeepers and officials with the main hotel workers union, Unite Here, said that housekeepers were often too embarrassed or scared to report incidents to management or the police. Sometimes they fear that management, often embracing the motto “the customer is always right,” will believe the customer over the housekeeper and that the worker may end up getting fired.

Ms. Babbington said a co-worker once encountered a naked guest who chased her around the room. “She was just panicking,” Ms. Babbington said. “She was very new in the country and she demanded to talk to the police. Her manager sat her down to calm her down and told her not to call the police, that it wouldn’t be good for the hotel.”

Personal comment: This is something the Hotel/Resort industry really doesn’t want to talk about since no property wants to get the reputation of having sexual attacks occurring on the premises, though we all know that a certain amount of it does occur. Because Vegas is a party and convention town you might expect that we would see a higher incidence of this sort of behavior, but that doesn’t seem to be the case. Perhaps because encounters are so easily arranged in any of the thousands of bars cabarets and lounges in town.

Strauss-Kahn fallout

Grope central - IMF Headquarters Washington, DC

The Washington Post
May 20, 2011
By Howard Schneider and Mary Pat Flaherty

IMF moves to bolster ethics rules prompted by ex-chief’s 2008 affair

“As it copes with the fallout from its former chief’s arrest on sexual-assault charges, the International Monetary Fund is still working to recover from Dominique Strauss-Kahn’s 2008 affair with a staff member — an incident that triggered reform of the agency’s ethics laws and new training programs for employees.

On May 6, the agency put in place new rules ordering staff members to disclose relationships that develop among them so that any conflict of interest can be resolved. That was not required in 2008, when Strauss-Kahn had an affair with IMF staffer Piroska Nagy. After a board investigation, he kept his job.

Virginia Canter, the IMF’s ethics officer and a former White House associate counsel, said she is also rolling out new harassment training programs for the IMF’s 2,400-person staff and hopes to make them mandatory. She has already held personal training sessions with about 400 managers and new employees.

In an interview, she said there was nothing about Strauss-Kahn’s arrest last weekend while on a private trip to New York that she felt warranted a review of the IMF’s ethics policies. She said she regarded the policies as “solid” following the recent revisions. Those changes toughened the harassment and ethics rules for all employees, including the managing director, in line with recommendations made by an outside lawyer who investigated Strauss-Kahn’s 2008 affair. Like the World Bank and similar international institutions, the IMF is not subject to U.S. workplace laws.

“I did not have a heart attack when I walked in here” and took over the IMF ethics operation in 2010, Canter said. Of the internal ethics breaches alleged during 2009 and 2010, none related to sexual harassment between managers and subordinates, she said.

The former IMF chief, until this week a possible contender for the French presidency, was released from New York’s Rikers Island jail Friday after posting $1 million bail and agreeing to electronic monitoring of his movements and 24-hour-a-day surveillance by an armed guard. He will be confined to a New York apartment until trial, although it is unclear which one: His initial attempt to secure lodging fell through after building residents complained about the media attention and potential disruption.

Also on Friday, the IMF board set new procedures for choosing Strauss-Kahn’s replacement, which open the door for non-Europeans to compete for the post. By tradition, the IMF’s top job since World War II has been held by a European, but the process outlined by the board allows any of the fund’s members to nominate a candidate. Nominations will be accepted until June 10. The board said it will develop a shortlist of three candidates to interview and try to make a decision “by consensus” by July 1.

That puts the process on a faster track than the three months needed for Strauss-Kahn’s selection, but it also is a response to developing nations’ calls for a more open competition and clearer selection process.

Strauss-Kahn’s indictment on seven counts, including attempted rape, has refocused attention on the 2008 staff affair and what some believe is lax oversight of the fund’s top management by its 24-member executive board.

An outside investigation by the Morgan Lewis law firm resulted in a reprimand by the board and an apology by Strauss-Kahn for a lapse in judgment.

The body — in part appointed by major powers like the United States and chosen by groups of smaller nations assembled from among the IMF’s members — is a “resident board,” meaning its members are paid a full-time salary of $230,000 a year and have offices at IMF’s headquarters. While expected to oversee the managing director, they also work with him and other staff on a day-to-day basis.

The same people who review the managing director’s performance — or, in Strauss-Kahn’s case, decided to keep him despite the Nagy affair — might also make appeals to him if their country needs help. The senior member and “dean” of the board is A. Shakour Shaalan, an Egyptian who was a veteran of the IMF staff before joining the executive board in 1992, where he has since remained, representing a collection of Arab states.

Shaalan, 82, did not respond to requests for an interview.

“It is a really widespread concern,” said one former executive director, who spoke on the condition of anonymity because of the sensitivity of the issue. “They want a favorable report [for their country], then they are supposed to oversee the managing director and the functioning of the institution. There is an inevitable tension. They are structurally dependent on the managing director.”

The U.S. executive director, Meg Lundsager, appointed by the Treasury Department, did not respond to an interview request.

The changes underway at the IMF in part track policies developed at its sister organization, the World Bank, which went through its own soul-searching after then-president Paul Wolfowitz’s resignation over pay and other benefits given to a female staffer.

The World Bank considers relationships between an employee and a manager “a de facto conflict of interest” and requires employees to take mandatory training on misconduct, including sexual harassment.

Female IMF staff said in interviews that they, like all employees at the agency, were rattled by Strauss-Kahn’s arrest, but they were hesitant to criticize the board’s decision to retain him and said they thought his behavior was not representative of the agency.

Staff writer Brady Dennis in New York contributed to this report.”

Personal comment: I helped fit two European members of the IMF staff with diaphragms about 18 months ago while they were in Vegas for a conference. I thought European women preferred cervical caps, but they both said that the men they worked for preferred they wear diaphragms and were told to ask for Reflexions flat spring devices because their lovers liked the feel of thrusting into the stretchy latex dome. These women were midlevel staffers in their early 30s and on the pill so they were using their Reflexions as fetish devices, which I thought was pretty amazing and great, for their bosses.

Friday, May 20, 2011

Pointe shoe quiz May 19, 2011

Who is the maker of this dancer’s shoes?

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Powys , Wales, United Kingdom
I'm a classically trained dancer and SAB grad. A Dance Captain and go-to girl overseeing high-roller entertainment for a major casino/resort