Life, Love & Health

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CS: I’m Christopher Springmann and we’re broadcasting from the Twenty-ninth Annual Medical Communications Conference sponsored by the American Medical Association. My co-host is Dr. Teresa Knight, an OB/GYN, obstetrician/gynecologist, who practices in St. Louis, Missouri. Dr. Knight, how are you today?
TK: I feel great, thanks.
CS: You spent the last three days here, a unique opportunity, at the AMA Medical Communications Conference to learn from, well, experts and gain new insights and enhance and develop your communication skills.
TK: And it has been really a journey. The amazing thing about this conference is that you get the opportunity to meet people who are medical communicators, who have made it their job to try to communicate what it is that they do in medicine to other physicians and to the public at large. And what’s really great too is the opportunity to talk to other physicians from other specialties and hear what it is that they are doing to help increase health awareness.
CS: And one of the reasons the AMA has the Medical Communications Conference and has for the last 29 years is that they understand the importance that health-related information be delivered by people who know and understand the news media and the science behind the headlines and how’s this for a segue, much like our next guest?
TK: Ooh, our next guest, I’m very excited to talk about. She’s written about a subject near and dear to my heart. Her name is Dr. Jill Grimes. And she is a practicing family practice physician from Texas. And she has written a wonderful book entitled Seductive Delusions.
CS: How everyday people catch STDs, and they probably catch them the old fashioned way, don’t they, doctor?
JG: Yes, they certainly do.
CS: And everyday people are often surprised, despite their best efforts and their best prevention strategies, that an STD, if you’ll pardon the mixed metaphor, sort of comes knocking on the door and greets them in unexpected ways.
JG: Absolutely. And that’s exactly why I wrote this book is because there are so many people who have the misperception that STDs belong to this tiny little segment of society. It’s them over there, not us over here.
CS: Those people.
JG: Those kind of people.
CS: But in reality, we are those people.
JG: That’s exactly right, with one in five adult Americans having genital herpes, even though 90% of them don’t know it, yes, us.
CS: What is the danger of having genital herpes?
TK: Well —
CS: And perhaps both of you could speak to that.
TK: You know, it’s funny, I immediately started answering that question, sorry, Dr. Grimes.
CS: No, please do.
JG: You’re the expert also.
TK: You know, with herpes, thankfully, it’s not a virus that causes cancer. The problem with herpes is that it is a virus. And like all viruses, once you have it, it stays with you.
CS: And also you may visit herpes, herpes simplex is it?
JG: Well, it depends on the location as to what, or how the virus presents itself, what you would call it.
CS: But you may visit that herpes on your newborn child if you have a vaginal birth, is that correct, doctor?
JG: Absolutely. Actually I probably should defer to the obstetrician, but that is one of the consequences of herpes that we are concerned about.
TK: Absolutely.
CS: Undiagnosed herpes.
TK: Right, that would be the only health concern, the only public health concern with herpes is that if you have an active outbreak of herpes it is a contraindication to a vaginal delivery because when the baby passes through the birth canal, the baby can become infected with a virus and with such a new not very strong immune system then the virus can be devastating.
CS: Tell me, Dr. Grimes, how traditionally, how typically do everyday people catch STDs, sexually transmitted diseases?
JG: Well, the number one way that I see that people are catching STDs, in fact herpes since we’re on the topic, is actually through oral sex. And since people rarely use condoms for oral sex, it’s more easily transmitted. Those cold sores that everyone has on their mouth, in fact the estimates range between 50% and 80% of adult Americans have herpes in their mouth, whether they get blisters or not, that herpes can be transmitted from person A’s mouth to person B’s genitals.
TK: And this is the crazy thing about herpes, type 1 herpes, that we currently or most commonly call herpes simplex when it’s located on the lips, you can get it from kissing your mother. But then you can give it to your sexual partner during oral sex. So it’s very happy to live either on the lips of the mouth or on the lips down below.
CS: The book is divided into fascinating chapters, herpes simplex, of course, virus, HPV or human papilloma virus, cervical cancer, Chlamydia, gee, doctor, what is the prevalence of chlamydia in the United States these days?
JG: Well, thank you for asking that. Actually our 2007 statistics, which are the most recent ones that we have from the CDC, showed the sad fact that we’ve reached over a million cases, 1.1 million cases in the United States. And why is that important? Why does chlamydia matter? Because it can cause pelvic inflammatory disease which leads to infertility and chronic pelvic pain.
CS: You divide the book into not only these specific chapters, but you also give case histories. For example, here we have Tony, who could be a composite.
JG: And Lydia with chlamydia.
CS: Lydia with chlamydia. Discussing their cases, and he apparently acquired something that his friends joked about as whiskey dick. What is that?
JG: Well, that is a little off topic. That has to do with reason that many young men will not wear a condom because it’s more difficult for them to perform if they can’t feel very much after consuming too much alcohol, which happens frequently with binge drinking on college campuses and other places.
CS: Well, it’s not that far off topic in the sense that people are reluctant, in the case of our Tony, not to use a condom because of some performance anxiety, and therefore shares his chlamydia.
JG: Well, I don’t know that it’s performance anxiety; it may be more of an excuse and there is that as well. But I think, you know, one of the big misconceptions, since we’re talking about condoms and, is that people feel that if they use condoms and they use them 100% of the time that they have 0% chance of catching an STD. And that is an enormous myth because condoms work terrific for the sexually transmitted infections that are transmitted by body fluids. Obviously they’re not going to work if for the diseases that are spread by direct skin to skin contact because you have skin outside the area that a condom covers.
TK: And I’m so delighted, so delighted, to have this book and so delighted to hear you say that because I feel like a broken record sometimes saying that again and again and again in the office. And if the listeners could take nothing else home from this talk, the two things that I’d like for them to know is that you absolutely can get herpes and the human papilloma virus, HPV, even if you perfectly use a condom and also that you can get those things in your mouth.
CS: The title of your book is very, well, provocative, Seduction Delusions, but with the emphasis on the capital D of delusions because what you don’t know may hurt you and your partners, assuming that…
JG: A moment of passion can lead to a lifetime of disease, absolutely.
CS: Well, let’s talk about HPV. There is a wonderful vaccine out there now called?
JG: Gardasil.
CS: And apparently it may be recommended for young men, is that correct?
JG: Yes, absolutely. They are looking at that, and the reason that that is being looked at by researchers is that we’re finding that the human papilloma virus, HPV, not only causes cervical cancers, but now we have found a link between that same virus and mouth cancers.
CS: Really?
TK: Absolutely. And actually a funny story when we were chatting earlier is, and I went to my dentist to have my teeth cleaned and he did the cancer screening for human papilloma virus and I said, oh, a lot of people must be having oral sex and he said, what, what are you talking about? He didn’t realize that it was the same virus. So very, very important for people to realize that. And the other thing that I really was happy to see you chat about is that these STDs are part of doing business, if you will, it’s a part of having sexual relations, but once you have them, it should not also be a scarlet letter.
JG: Absolutely not.
TK: And please talk a little bit about that.
JG: Well, you know, no one part of a person should define them, and that goes for whether it’s a disease or your financial status. And so you’re not going to be defined. If you have herpes, well, guess what? So do a heck of a lot of other Americans.
TK: Millions.
JG: Exactly, 20 million Americans have active HPV. So you’re not some isolated person off to the side. This is something that everyday people catch, and it is something you need to be aware of and you need to know the risks of, but it doesn’t mean that you need to be a social outcast.
CS: In the ideal world, Dr. Grimes, what is the best time to read Seductive Delusions, perhaps?
JG: Before the first date. You absolutely want to, you, as a parent you need to know this information so you can have the talks with your children, including your family values in addition to just the straight medical risks. But for high school students and college students, the great thing about this book is that they’re actually interested in reading it. It’s stories, not just statistics.
TK: Absolutely, and that’s what I love about this book, the little vignettes, the little stories, very well written.
JG: Thank you.
TK: And really lure you in. It’s like reading a story for fun and it’s a perfect book for a 16 year old birthday or for a girl going off to college. I’d like to see them —
JG: [Inaudible].
TK: Yes.
JG: It’s a great high school graduation gift or a eighth grade graduation gift.
TK: It really is.
CS: Our guest today has been Dr. Jill Grimes, a practicing physician at the Westlake Family Practice in Austin, Texas, and she’s also a clinical faculty member at the University of Massachusetts Medical School. Thank you so much for joining us today, doctor. For more information about any of our guests and shows, log onto I’m Christopher Springmann, and my co-host is Dr. Teresa Knight, OB/GYN, obstetrician/gynecologist. You’re listening to Life, Love, and Health, Special Edition.