My husband and I went to Europe for 18 days and returned home late on Saturday, September 24. After being gone so long in a time zone that was 6 hours different from where we live in North Carolina, I am finally getting my being back into some sort of equilibrium. Even with the sluggishness and the angst that I have tons to do now that I am home, I would go again. I love to travel, especially when it involves visiting places that I have always wanted to see. Even with the ability of the Internet to allow us to view locales just about anywhere in the world, it just isn’t the same as being there.

On this trip we traveled from Normandy, France to Southern Spain and also spent a day in Tangier, Morocco. While there, we ate wonderful foods, drank fabulous wines, saw sites we planned on visiting and some that I didn’t even know existed. All in all, we had a wonderful time. Having said that, people keep asking me to name my favorite place. Despite the fact that my first post-vacation blog post was about European Potties, my favorite places were just about everywhere except bathrooms. However, I would change the question to ask what place was our biggest surprise – and that was the Moroccan city of Tangier.

Thanks to our excellent guide Yoseph, we spent a day in Tangier and toured just about the whole city, from the beaches on the Mediterranean to the Atlantic shores and the Rif Mountains that surround the city. Not surprisingly, the waters of the Atlantic were rougher and cloudier than the clearer and very blue Mediterranean, which was the only demarcation of waters that flowed into each other with no divider.

To get to Morocco from Southern Spain, you take a ferry from the Spanish city of Tariff and go across the Strait of Gibraltar, which takes about 45 minutes of actual travel time. From what I understand (and this happened for us both coming and going), the trip can expand to almost 2 hours with delays. After visiting, the only impression I had of Tangier before was all WRONG!  It is a very progressive and culturally diverse city that seems to welcome everyone, as they have for thousands of years, whether they are Christian, Moslem or Jewish. 

We went to the beautiful seaside, I rode a camel on the beach (though not really willingly), went to fruit & vegetable markets, meat and fish markets and visited a beautiful old Synagogue in the heart of the Jewish section of the city.  I almost cried to know that there is such an acceptance of my people in an Arab country.  Wish everywhere could be like that. 

Our lunch in Tangier was fresh and delicious. We started with a bowl of olives and a salad of fresh tomatoes and onions in olive oil and vinegar. Then we ate: grilled lamb kabobs, couscous with chicken, and a Moroccan lamb stew with prunes and chickpeas that was seasoned with saffron, cumin and garlic. When ordering, we just told the waiter to bring his best offerings. YUMMM! I washed it all down with a locally made crisp and light white wine. Another positive about Morocco is that they have vineyards and produce delicious wines! I was a bit frightened after the fact that I might get some sort of traveler’s issue due to a more sensitive constitution than my husband, but all was good!! 

Another point that just popped into my head is that the King of Morocco’s chief advisor is Jewish.  Also, women and men, regardless of religion or culture, serve equally in all occupations as well as in the government.  Gotta love a place like that.

You know you really liked a place when you want to go back – and I do!! Next time Marrakesh and Casablanca, but not for a while!

My husband and I just returned from a fantastic European vacation where we traveled to France and Spain mostly. We also crossed the strait of Gibraltar in a ferry and spent a day in Morocco. I didn’t blog about my trip while traveling due to concerns about security at home. It is crazy that there are people who go to public sites for the sole purpose of determining who’s away from home so they can rob their house. I have read online security tips advising not to do that, using, as an example, some poor family who posted publically while they were on vacation. They came home and found that someone ransacked their house while they were riding the waves in some remote location. In any case, I have a lot I want to share, now that I am back, and will begin with public washrooms.

The reason I am starting with the topic of public potties, rather then going on about the delicious food we ate, fabulous wine we drank (a glass of wine costs about as much as a cup of coffee in many places), and sites we saw is because I have a thing about cleanliness and hand washing. We all know that hand washing can prevent the spread of diseases, important to do all the time, but even more so when away from home and as we enter flu season. If we all supposedly know we should wash our hands after going to the bathroom, then why doesn’t everyone do that?? I have witnessed women bolting the bathroom without washing their hands. There is no excuse. Instead of being NurseElaine in a starched white uniform and going on about germs, disease and prevention, I thought I would talk about the public bathrooms in Europe and what I liked about them. Believe me, there is no way I would talk about the U.S. public restrooms as I find most of them gross.

1) Always Found Soap: Yep, in the vast majority of bathrooms I used there was soap. And, if you have read my posts on incontinence and also read what I have written about urinary tract infections, you would know that I have visit many, many public restrooms while traveling. In fact, I would argue that I visited many, many different bathrooms in a day sometimes. On our recent vacation, I can’t remember not using a bathroom that didn’t have a soap dispenser of some kind. This includes toilets at different landmarks, airports, train stations, auto rest stops, restaurants and small bars located in alleys. Soap is present and where there is soap there is the potential for good personal hygiene after using the toilet.

2) Most restrooms were clean: Love the fact that while some of the toilets I visited had really old fixtures, lighting that looked like it was from the 1930s, and tile floors and walls that were original to very old buildings, they were clean. I don’t know if it is a pride thing or just a better understanding of the importance of cleanliness when you are providing services to tourists, but I was happy to see that. In fact, I would argue that I see more yucky potties in the U.S. then I’ve ever found abroad. For example, I was talking to my next-door neighbor’s mother yesterday who mentioned that she had also been to Morocco. She told me that a restroom she used, when traveling there many years ago, was spotless. The only thing that was disturbing to her was the man who continued to mop between the toilets even while women were using them. Then, he expected a tip. She gave him one!

Years ago while in Hamburg, Germany, I went into a public restroom at the train station and backed out hurriedly because there was a tall man in a butchers coat in there. Checked the sign on the door again and, sure enough, it was the ladies room. He was there to keep the room clean and he did. It was spotless and I gladly tipped him. Now there is a jobs program that could be implemented in the U.S. I’d be happy to designate my tax dollars to ensuring clean public restrooms and filled soap dispensers. Could reduce infections and save insurance providers billions of dollars. I am kidding – sort of!!

3) Very few paper towels for hand wiping after washing: Don’t know if that is a cost savings thing or not wanting to waste paper, but I didn’t like that. Often there were hand dryers, but many didn’t work. In any case, I sometimes just air dried my hands by waving them while walking or wiped excess water on my pants. Oh well, at least I washed with soap.

4) Mostly found toilet paper: Important to always carry your own pack of tissues or wipes, because you never know if there will or won’t be paper. One thing I liked is that when there wasn’t, the woman before me would mention it and offer me paper. That happened more than once. Wish we could all cooperate on more complex things too, but I appreciated the kindness of the warning.

5) Didn’t see many tampon or pad vending machines: The only place I saw vending machines were in airport or train station bathrooms. So, be prepared and take product with you if you even remotely think you will need it. Recently in the U.S. in Pinehurst, North Carolina, where you find many very exclusive golf clubs, I visited the Pinehurst Country Club that houses Course No. 2. I am not a golfer, nor do I belong to that club but it is supposed to be a really big deal if you play golf there. We had friends visiting that wanted to go to Pinehurst. Of course while there I had to use the bathroom. Along with cloth wipes the Club had complimentary Tampax sitting in cute little baskets. That doesn’t happen often, so again, take some if you think you may need it.

6) No buggies on the walls: OK, that is me with my bug phobia and not wanting a spider to fall into my bushy wild hair. Hate when I see spider webs in bathrooms and I truly didn’t see any. Made for a much more relaxed experience.

7) Found many bathrooms with high stall walls: I have always hated bathroom stalls that had short metal pieces as dividers, as they afford absolutely no privacy. You might as well place the potty in the middle of the room. In Europe, I most frequently found high walls between the stalls or even some bathrooms that were individual rooms with their own lights. It kind of made me feel at home. In any case, this is just a non-hygiene observation that I wanted to share.

For those of you have stuck with me and read this blog, I want to reiterate that I am writing about the ladies rooms in Europe as a way to talk about hand washing after using the bathroom. According to the Center for Disease Control, “Keeping hands clean through improved hand hygiene is one of the most important steps we can take to avoid getting sick and spreading germs to others.” If no soap, use antibacterial cleanser, as you owe it to yourself and others! I promise that my next blog will be about the wonderful sites we visited and there will be no mention of potties!

It has been a while since I lasted posted and that is because life happens. No doubt many of you are shaking your head in understanding on that comment. Earlier this month, I attended the BlogHer ’11 conference in San Diego and had a great time talking to others about their blogs and about mine. I met mothers of teens who expressed interest in the beinggirl.com website, women with health concerns who identify with some of the issues we face due to our changing bodies while aging, and women who write about their families and businesses. To those I met, thanks for spending the time, as that above everything else made my experience rich.

While at Blogher’11, I exchanged business cards with almost 150 people. After returning home, I went to each and every site to see what others are doing. I saw a whole range from sophisticated sites with sponsors and great graphics to simple sites with interesting stories to tell. It was fascinating to see, as I usually focus on health sites that are done by professional organizations. The sites brought me into a personal place and I felt admiration for those who wrote about their most poignant experiences.

Additionally, loved the fun and crazy sites that made me laugh out loud as I identified with experiences that made me crazy at certain times in my life. What I truly appreciated is that we all share so many common experiences. Our approach and perception differs and that is what makes life so interesting.

Another aspect of Blogher ’11 that I totally enjoyed was the sponsor booths. Yep, I am still: eating deliciously smooth Lindt chocolate (see Lindt, I was listening), asking every McDonalds I buy happy meals at if they have the half french-fries and half apple meals, starting to do budget stuff on the Chase website, enjoying delicious Kudo bars that are more nutritious than I realized and sharing with my grandchildren fun toys and games from Nickelodeon that I was generously given as I passed by their display. Loved the Jimmy Dean sausage, the cookbooks and the sex toys (actually, I was surprised to see the company but everyone carried their totes around with their give-a-ways wrapped inside with tissue.). Big thanks to Yahoo for the great book on blogging. You are helping me improve! CVS, love the mini clinics that have saved me lots of time while making me healthier. Enjoying the books recommended by sassymonkey and am now a Blogher book club member. Thanks sassymonkey!!

Lastly, thank you Tampax and Always for making it possible for to attend Blogher ’11 and to P&G for giving me space in the P&G house bathroom where I could chit chat with other bloggers passing through. I stood near the Charmin potty. Actually, when no one was around, I had a photo taken of me with the Charmin Bear. My grandkids were impressed that I met the Charmin bear and I made sure they knew that the Charmin Bear always washes his hands after he uses the potty.

In ending, a big SHOUT OUT to my new friends and I am looking forward to bloging about what I enjoy most: women’s health, teens, periods and products!

I have a friend who is a registered nurse and an attorney employed by a Health Maintenance Organization (HMO) type of institution as a lawyer. However, she has been a women’s health advocate for many years. Her HMO recognizes that and has asked her to serve on a community panel with the goal to develop strategies to improve local health care services for women.

She recently asked me what I think excellence looks like when it comes to women’s healthcare. I immediately thought of my physicians. Yes, I said physicians in the plural because I have an OBGyn (now strictly gynecology, since I am long past any OB needed services!), an internist (fortunately nothing more serious than colds, occasional stomach aches and biannual physicals), a dermatologist (to tell me that the spots on my face aren’t cancer but the result of sun and age), and an orthopedic surgeon (yes, I am a baby boomer who used to jog and ruptured a disc 12 years ago. Old back injuries just keep on giving and not in a good way). Two are women and two are men. I think all are excellent practitioners. The question is why do I think that and what does that have to do with women’s health services in the general. Read on and I will share some thoughts of what I think constitutes excellent women’s health services:

Treats me like a person, not just a generic no-name patient: When I go to the doctor for a health care check-up or when I am ill, I want to be viewed as a total person. I am a mother, a grandmother, a wife, and a professional, vain, happy, in excellent health mostly, weigh more than I should or want, independent, menopausal and a health communicator. Actually, I am more than that, but the point being is that I not just a random person who comes into the office and then gets called the generic PATIENT. Even if it is a first visit, I want the physician and staff to call me by my name. I am not a stickler for first or last name, just want them to know my name and look me in the eye when we talk.

Has excellent credentials: We moved to our current location almost 4 years ago from a city and state my husband and I had lived in for all of our adult lives. Needless to say, we left behind trusted medical specialists, dentists, ophthalmologists and hair stylists, amongst other service providers. Before making new appointments, I checked out who were part of the network for my health insurance provider. Then, I googled the doctors I was considering to make certain that they were board certified in their fields and had gone to well-respected universities. It was also helpful to review local medial review sites to see what others thought about the doctors. Then, I made my appointments with the thought that if I didn’t feel comfortable with the doctor, I could change practices. So far, I really like my choices.

Asks me questions to clarify and explains treatment options: Years ago, I went to see a doctor because I was feeling really tired and worn out. At the time, my daughter was very young and active, I was working as a nurse on the afternoon or night shift, I was taking classes to earn my BSN in nursing and doing all of the other stuff that I enjoyed in the spare time that I had left. I told the doctor about all of my activities. In any case, the doctor took blood from me, which I assumed was to check to for anemia or something worse and prescribed a medication, which I hadn’t heard of before. He told me to take it for 2 months and then let him know how it was working. Before filling the prescription, I looked up the drug in the PDR (Physician’s Drug Reference). This was way before Internet! What I found was that the medication was an antidepressant. I couldn’t believe it! In hindsight, the doctor asked if I was depressed and I said something like NOT REALLY, but I do feel kind of down when I am so tired. In any case, I never filled the prescription, nor did I return to the doctor. He made a wrong assumption based on little information. While I don’t expect to sit in an office for hours, I do want to be told why the doctor prescribed as he did and not be coy. Obviously I am still aggravated about that.

Takes the team approach: While my health care professional is the expert, I am the person that needs to adhere to any treatment options that are prescribed. We have to agree that I will do what is recommended or it won’t work. For example, I hate to take medication and would rather find ways to seek wellness without drugs. There are ways to help avoid problems, such as diet modifications if one is constipated or weight loss, physical therapy and exercise instead of pain medication. No doubt that there are times when medications are needed to fight infections or for other issues, but there are also precautions one can take to help avoid the need. An example is that I try to avoid visiting my grandchildren when they are coughing, sneezing and vomiting. Recently we were all vacationing together and 2 of the little ones were feverish, lethargic and hacking away. They were placed on antibiotics and felt better within 24-hours. Then, I got sick and took antibiotics too. The point I am making is that sometimes you have to do what you have to do in regards to meds, but sometimes there are other ways. It is important for me to have an HCP that works with me to develop other approaches to health and I consider that excellence in health care.

Stays current in their field of expertise: Consumers today are kept apprised of advances in health care because of the ease of access of information on the Internet. We expect our health care providers to do the same. When I ask a question, I appreciate a nod from my doctor letting me know he is aware of what I read and why I am asking the question. We then have a brief talk about why or why not what I read is appropriate for my specific situation. Also, I want to hear from my HCP too about some new advance that can work for me. Once in awhile one of my HCPs will tell me about something he or she learned at a medical conference. That is big to me because I know they are interested in learning about the latest and greatest in research and practice and not just falling back on the old and outdated.

Ease of access or location, location, location: One thing I have begun to appreciate lately are HCPs that have several office locations around the city. This way, I can book an appointment on the day of the week the doctor is in the office closest to where I live. Love when I don’t have to plan a half-day around a 15- minute office visit.

Summary: Note that I what I have included as components of women’s health services aren’t really specific to women’s health. They are aspect of clinical practice that could apply to both genders. Perhaps that is the key. I believe that the women’s health component is more related to a HCPs appreciation that I am a woman and that my treatment should be specific to my gender and my needs as a female consumer of health and wellness. To my friend: Sorry I wasn’t more helpful. Perhaps those reading this can offer suggestions that will be more insightful as your committee seeks to improve women’s healthcare services in your community.

Please post any ideas that I can pass along and THANK YOU!

Actually, for me the title should be how NOT to look BIG in photos. UGH. For Father’s Day, my husband received a beautifully framed large family picture from my lovely stepdaughter. Everyone in the picture looks great, except me. And believe me, this is not false modesty. What a nice gift though, but I wish I could photo shop another me in the picture.

While thinking about this and looking through the beinggirl.com website, I found an article titled, How to Look Good in Pictures. I hadn’t seen it before, but wish I had read it previously so I could have applied some of the suggestions to recent family photo taking.

The beinggirl.com article includes tips on how to stand and what to wear. For example, avoid bright white clothing, as it will wash you out. The article also advised on how to hold your chin, to avoid circles under your eyes.

My very favorite tip is about how to look slimmer: “For those who want to look thinner in photos, position yourself at a 45-degree angle to the camera. Don’t press your arms against your sides. Keep them slightly away from your body to make them look svelter. Angling one hip toward the camera can make you shed pounds visually. To make your waist appear smaller, put your hands on your hips with thumbs pointed down in and you’ll always look good in pictures!”

Would you believe that I have been practicing the “how to look slimmer when being photographed” tip for those moments of spontaneous picture taking. This is the pose that I see celebrities taking when being shot on the red-carpet during awards shows, movie premiers and while shopping in the grocery and being caught by the paparazzi. While I don’t have people following me to take my picture, it is just as important to me to look good in family and friend pictures that will be visible to me, and others, for decades. Since I am uncoordinated and can’t even repeat Pilate’s exercises that I have done for years without looking at the instructor, it is important that I practice, practice and practice posing when ever I think about it. I posed recently in a department store parking lot and people nearby (that I hadn’t noticed before beginning) looked around to see who I was smiling at, then looked at me funny and walked further to the entrance to avoid me. Oh well!

While I am focusing on how to pose (since I am somewhat vain and controlling) the article also advises that you should try to “look natural”. The reason for that is you don’t want to loose the emotion that is present in spontaneous picture taking. I am all for that too. But believe me, emotion is something that I don’t have to practice! While I say that I would rather look bland than big, I do like the natural looks of joy in others that sometimes is evident when photos are taken. In fact, I agree with beinggirl, emotion can be the true essence of the photo when there are people present.

I posted a link below to the article. I would love to hear other suggestions anyone may have on how to look great when pictures are being taken. Hopefully they won’t require rehearsing!

http://www.beinggirl.com/article/look-good-in-pictures/?utm_source=wordpress&utm_medium=NursePlummer&utm_content=link20110628&utm_campaign=comm_mgr