A family friend recently had knee surgery. The procedure went well, and prior to leaving the hospital, the nurse gave him discharge instructions. He can walk, but he can't drive. He can return to work and resume certain upper body exercises next week, but can only perform lower-body exercises once he starts physical therapy in three weeks.

The detailed discharge instructions that he received made me think about a friend's comment to “Exit Only.” In that post, I answered a reader's question about how to broach the fact that her medical issues impede her from having anal sex with her boyfriend. In the comments section, a friend indicated that she wouldn't feel comfortable talking to her doctor about sex. I don’t think she’s alone in that sentiment.

In a recent study of female cancer patients conducted by the University of Chicago Medical Center, 42% wanted to talk to their doctors about sexual health issues. Only 7% of these women — who ranged in age from 21 to 88 with an average age of 55 — had done so.These patients didn't just want to talk about sex with their doctors. They needed to talk about sex with their doctors.

In thinking of those statistics, I believe that both the doctors and the patients are to blame. As adults, we all need to learn how to advocate for ourselves and our loved ones in a medical setting. (Illness is an unfortunate, but inevitable part of life.) And, health care professionals working outside of pediatrics should operate under the assumption that all of their patients are having sex and advise them accordingly.

“Anything that affects the female sexual organs will have repercussions on body image and on a woman's sex life," said Emily Hill, MD, a fourth year resident in obstetrics and gynecology at the University of Chicago Medical Center, and lead author of the study.

Peggy Brick, a renowned sex educator in her 80s, opens her speaking engagements with one question:

Why do we stop learning about sex around the time we start having it?

She explores how each age and stage bring with it different changes to our lives. Peggy then asks us to think about how we can address the physical and emotional ramifications of these changes in a way that continues to prioritize our need for intimacy.

I maintain that talking about these life changes and their impact on our sexual health is important. In some instances, that will mean having a conversation with your partner, a friend, a therapist or a clergyman. In others, that will mean having a frank discussion with your doctor.

Assuming that you have health insurance and have some choice about which doctor you see, select a physician with whom you feel comfortable. Evaluate the doctor's bedside manner along with his or her education, experience and location. If you can't imagine talking to your doctor about any medical issues that you have or potentially could have (including, but not limited to, urination, constipation, diarrhea, your period, changes in your testicles, a lump in your breast, your sex drive, and depression), then find another doctor!

If you are recovering from surgery or have an injury or health condition, the only way to find out what you are or are not allowed to do is to ask your doctor. And, when you ask, be specific. It's not always enough to inquire as to whether or not you can have sex since you can achieve orgasm by more than one means. For those of you who have sex toys or engage in anal sex, don't assume that a temporary ban on sex does or doesn't allow you to partake in those activities. Ask.

If you don't feel comfortable talking about medical issues directly with your doctor, you can:

1. Write your questions down on a piece of paper and present the paper to your doctor;
2. Ask your doctor for his or her email for follow-up questions; or
3. Broach the topic with a nurse, physician's assistant, technician or receptionist with whom you have a good rapport. That person will either forward your questions to the doctor or answer you himself or herself.

For those of you in the medical profession, it's worth inquiring about your practice’s policies regarding sexual health issues. If the practice appreciates the need for these conversations to happen, how can you respectfully convey that information to patients? (A brief comment during a consultation, a card or pamphlet in the waiting room, or a sentence on a patient form should do the trick.) When it comes to post-surgical or post-treatment discharge instructions, include helpful guidelines regarding sex. A one-line instruction now could save a patient from complications later.

Medical problems arise. Sex is a healthy and natural part of life. Isn't it time for us all to recognize how one impacts the other?

Have you talked to your doctor about a sexual health or sensitive medical issue? I'd love to hear from those who have, as well as those who haven't felt comfortable enough to do so.

Mr. Agency and I were both out of town in early October.  I had planned to return from Manhattan on Thursday, but Mr. Agency wasn’t entirely sure when he would get back to DC.

Mr. Agency: I’ll see you when I get back over the weekend.

Me [always the planner]: Which night?

Mr. Agency: Either Friday or Saturday, depending on work.  I’ll come over the night I get back.

Me: Okay.  You aren’t heading back on Friday for the fundraiser?  [Once a month, there was a fundraiser at a neighborhood restaurant to benefit a cause that Mr. Agency supported.]

Mr. Agency: No.  If I make it back on Friday, I have another event.

I didn’t hear from Mr. Agency until Saturday morning.  He texted me that he had just gotten home and looked forward to seeing me that evening after work. 

During the day, I went to the salon to donate what was left of my hair to Locks of Love.  (In four days, I had lost half of my hair from chemotherapy.)  I hadn’t yet embraced the sexiness of the buzz cut, but I tried to fake it.  When Mr. Agency knocked on my door, I greeted him with red lace lingerie and four-inch stilettos.

He smiled and laughed since he hadn’t expected to see me like that.  I fixed him a drink and then we went into the bedroom.  On the surface, sex with Mr. Agency was as loving and intense as ever.  We embraced each other tightly throughout the act, peppering our moans of “more,” and “yes” with “I missed you so much.”   We both came, and when we were done, we discussed our weeks.  On the surface, everything was normal.

But, a part of me felt like there was an elephant in the room.  While we were having sex, Mr. Agency moved his hand to hold the back of my head.  When he touched my very short hair, he moved his hand away rather quickly.  Maybe it was just a coincidence, but I couldn’t help but think:

I was the girl with the long, sexy red hair.  Now, I'm the girl with the buzz cut, and soon I'll be the girl who is bald.

I didn’t cry or bring up my fears, but it seemed like Mr. Agency sensed what I needed.  He held me close and told me how sexy I was.  And, in the morning, when we had sex again, he told me much of the same before he headed off to the Redskins game.

Me: I’m going to turn into a pumpkin on Tuesday with the next round of chemotherapy.  Come over before then if you can.

Mr. Agency: Okay.

The following day, he texted me to wish me luck with my first television interview.  (If you'd like to see the interview and how I looked with the buzz cut, click here.)

On Tuesday, Mr. Agency texted me to let me know that he hoped that this round of chemotherapy was better than the first.  He texted me the next day, too, but he didn’t come over or offer to bring me anything like he had in the past.

The second round hit me harder, as I was on four different medications to combat the side effects from chemotherapy.  Two of the drugs caused irritability and temporary amnesia so I felt like a moody zombie.  On Wednesday, I finally texted Mr. Agency the question that I had been wondering:

Will I be seeing you anytime soon?

Mr. Agency: I hope to see you one night this weekend.

"Hoped?"  I thought to myself.  "One night!"

I stared at my cell phone with a confused expression on my face.  He seemed so blasé about his plans, and I didn’t understand why he wasn’t being as attentive as he had been previously.  Of course, his work was important, but I was going through treatment for cancer!

Later that day, my confusion mounted as I went on Facebook.  My news feed showed a photo of Mr. Agency and a friend…at the fundraiser…on Friday.

Did he really come home a night early and attend the event?

Why would he lie to me when he had to have known that there would be photographs taken there?

I had worried that cancer would be too much for us so early in our relationship.  Had I hit the nail on the head?

To be continued…

The week after Labor Day, Mr. Agency and I continued to spend a lot of time together in bed. 

Mr. Agency: I don’t understand those couples that don’t have a lot of sex.  I bet that most people wish that they had a sex life like ours.  [We laugh.]

In the midst of our Sex Fest, I noticed that Mr. Agency would bring up my ex-boyfriends…or guys who had wanted to date me…or athletes I didn’t know in real life, but he thought wanted to date me. 

His comments weren't entirely without merit.  DC is a very small town, and he did know several of my ex-boyfriends in real life.  And, I had also shared two funny stories with him early on about two public figures that had tried to date me.  (In retrospect, I realized that I shouldn’t have talked about that.)

I would joke about seeing photographs online of him and women at events, but his tone about "how all the guys love me" was more jealous than jovial.  It occurred to me that he needed validation that I cared about him.  I made sure to interject comments — while we were having sex and when we were apart – to let him know how happy he made me. 

Mr. Agency: You say that to all the boys.

Me: No, I don’t.  I'll just have to make sure that you realize that.

As we spent more and more time together, I could tell that Mr. Agency began to feel more comfortable.  I found myself smiling every time that I thought about him.

Mr. Agency and I became closer, while Best Boy was on vacation in Los Angeles.  I had received a text from my friend, D, that she unfortunately wouldn’t be able to see Best Boy when he was in California.  I hadn’t thought much about what I was going to do when Best Boy returned to DC, until my friend, T, asked:

You’re not still going to hook up with Best Boy now that you and Mr. Agency are having sex, are you?

Me: I hadn’t thought about it much.

T: I thought that Best Boy was just someone to have fun with, though.

Me: He is.

T: And, you and Mr. Agency are more like a couple.  You’re seeing a lot of each other now, right?

Me: Yeah.  I saw him Sunday and Tuesday, and he's coming over tonight [Thursday].

T: Well, now that you and Mr. Agency are having sex, how would you feel if you knew that he was having sex with another person?

After thinking about that for a minute, I replied:

I guess I would be hurt, even if I didn’t have a right to be.  [Pause.]  Maybe you’re right.  It might be easier to just focus on Mr. Agency and see where it goes, especially since I can't be more than friends with Best Boy.

While T and I were talking at Teatro Goldoni, Mr. Agency walked in.  I smiled, as he came over to say hello to both of us.

Me: I didn’t expect to see you!  What are you doing here?

Mr. Agency: Well, I had a few minutes between the embassy event and the agency dinner so I figured that I would come by to say hello.  I also knew that some of my friends would be here so I wanted to introduce you to them.  [I smile a big, toothy grin.]

He walked over to introduce me to Clark and Jared without realizing that I already knew Jared.

Jared: So…how do you two know each other?

Mr. Agency and I just looked at each other and giggled.  We giggled like we were in middle school.  He finally mentioned that we met at the Masquerade Party, as the two of us blushed awkwardly.

Mr. Agency [when Jared wasn’t listening]: I need to head out now, but I’ll come by later.

Me: Good!  I’m really glad you popped in.  See you later.  [We kiss on the cheek.]

I went back over to T, and we both thought that it was promising that Mr. Agency came by, if only for a few minutes.

T: I’ve never seen you like this.

Me: All giddy, you mean?

T: Yeah.

I was giddy about Mr. Agency.  I went home still swooning.  I made up my sofa bed on the chance that Mr. Agency couldn't sleep well in my bed, and I put out some lube and a cock ring.  I laid down to try to sleep for a couple of hours before he came over, but didn't get much rest since I didn't want to miss his call. 

When my phone vibrated at 2am, I awoke with a smile on my face.  But, my smile turned to a frown, when I read Mr. Agency's text:

Just got home from the dinner.  Going to get some sleep tonight.  I’ll see you soon, sexy.  Sleep well.

I stared at my phone incredulously.  Was he joking?

To be continued…

Boston Christian called me from the airport to update me on his dad’s status and say goodbye.  I was glad to have seen him that week in August 2010, but his visit also provided me with clarity.  Back in 2007, I had wondered if he and I were meant to date again.  Now, though, I realized that Boston Christian was meant to be my high school love, and my friend as an adult.

That evening, I received a text from Mr. Agency.  (Although we had talked the previous week, we hadn't seen each other since before my surgery.)

Mr. Agency: How are you feeling, sexy?

Me: Good!  Almost all recouped :).  You?

Mr. Agency: I’m good.  I have an event tonight.  If it doesn’t end too late, would you be up for some company?

Me: Of course!  And, it’s okay to come over whenever your event is done.  I’m up late.

Mr. Agency came over around midnight.  I grabbed him a drink, and we caught up on my couch.  It was always easy to talk with Mr. Agency, and I found his smile and laugh infectious.  We discussed a variety of topics from politics to sports to my surgery to the DC social scene.  Yet again, the more time we spent together getting to know each other, the more I liked him.

Since it was late, I asked if he wanted to spend the night.  When we got into bed, Mr. Agency kissed me for the first time.  There are those kisses that make me hot, and there are those kisses that are sweet.  My kiss with Mr. Agency fell into the latter category.  His lips warmed my heart and made me smile.  I wanted more, but I also knew that it was better if we took things slowly.  There was no need to rush into having sex with him.

We kissed for a while before I fell asleep in his arms.  One of my friends described Mr. Agency as a big, black teddy bear, and that label suited him perfectly.  An hour later, he rolled over and said:

It’s been a while since I’ve slept next to someone.  Do you mind if I move to the couch so I can get a good night's sleep?

Me: Not at all.  If you need more blankets or anything, let me know.

With some guys, I would have taken that personally.  But, Mr. Agency was a good guy.  If he needed his sleep, that was fine with me.  I rolled over and fell back to sleep. 

In the morning, I went into the living room to wake him.  We cuddled and kissed a bit more before he headed off to work.  He told me that we would see each other soon, and I knew that we would.  His extremely hectic schedule might prohibit him from taking me out on traditional dates, but that didn't mean that we couldn't spend time together in some capacity.

I felt content with my August line-up:

Mr. Agency was my Snuggle Buddy.

Best Boy was my Friend With Benefits.

That evening, I received a text from Best Boy, asking what I was doing later.  This was turning out to be quite the summer.

I was a bit surprised when one of the owners of Lotus Blooms gave me a book to review, rather than a product.  But, after reading Violet Blue’s The Smart Girl's Guide to the G-Spot, I’m very glad that she did!  Sex educator and best-selling author Blue is an entertaining and effective writer.  Reading this book feels more like you’re talking to a close girlfriend than delving into a clinical sex guide.  It’s a fairly quick read, but it’s chock full of information!

At a time when there is much literature about whether the G-Spot truly exists, Blue states on page vii:

The G-spot is…a real, tangible thing, like my breast and your clitoris, and you can even see it.  But for some reason, lots of people seem to think that the G-spot is a myth.  Or a rumor…No – it’s a real thing, and it makes you come, hard, period.  No deep wisdom, soul-searching or goddess worship necessary.  But a little knowledge helps.

In imparting her knowledge to her readers, Blue looks at what the G-Spot is, what it isn’t, how it got its name, how to see it, and how to explore it with fingers, a fist, a toy and a partner.  The guide offers recommendations for toys and lube to harness the power of G-Spot and useful tips such as urinating before you begin G-Spot play.  The author also suggests positions for G-Spot pleasure during sex and devotes a whole chapter to how to tap into your ability to ejaculate or squirt.  The informative sections are interspersed with four pieces of erotica by Alison Tyler.  If you need to set the mood before having some quality time with yourself, these hot stories should do the trick!

This book is beneficial for first-timers, as well as those women who are already very familiar with their G-Spots.  As a testament to the book’s appeal, a girlfriend picked it up from my coffee table and plowed through two chapters while waiting for me to get ready.  The next time she was over, she asked where the book was so that she could read some more!

I love how Blue reminds her readers that it’s okay to listen to their bodies.  She encourages every woman to find her G-Spot, while acknowledging that some women prefer to orgasm clitorally or anally.  The author also addresses how some females don’t want to squirt or ejaculate.  It’s all about what feels good and right to each of us!

If I was teaching a course on The Female Orgasm, The Smart Girl's Guide to the G-Spot, would be required reading!  Turn off your laptop, your television and your phone for an hour or two and relax with this guide.  You won’t be disappointed, and for $14.95, you’ll definitely get your money’s worth!

I can’t give this book less than my full Five Squeals of Approval!

* Pursuant to FTC Guidelines, I received this book free of charge in exchange for more honest assessment of the product.