women’s health

Brave to the Bone – for The Big Smoke

Brave to the Bone – for The Big Smoke

Here’s a little piece I wrote for a new publication out of Sydney, The Big Smoke…

From The New Yorker

From The New Yorker

A Killer Rack

I was chatting with a mate a while back about my desire to change careers, and she asked me if I felt I was an expert in anything.

“I dunno” I replied offhand. “Probably boobs.”

We laughed, because everyone knows Boob Men don’t come much bigger than me. What can I say? I’ve never been any different. All I know is that any time a decent set of boobs appears in front of me, I lose the ability to speak. I’m like a rugby league player trying to string a sentence together.

Lately though, boobs have been messing with a close friend of mine and they’re starting to lose their appeal. They’ve tried this before with other friends, even succeeded on two occasions in taking great women I knew. But this time I’ve been a little closer to the action, and it’s highlighted to me how little I understood of breasts at all.

I suspect some of us girls are a bit blasé about breast cancer. We are bombarded with ‘breast cancer’ messages and campaigns almost to the point of being desensitized by it all. We know to check our breasts and we know the risk factors from lifestyle choices. Sure it can kill us, but the statistics are on our side, and most of us know at least one woman who’s been diagnosed, had a lumpectomy and a round of treatment and come out of it the other side with little to show for it other than a new hairstyle.

Well, yes. Except, no. Big NO.

Breast cancer is horrible. It is a hideous, nasty, insidious disease that attacks us at the very core of our being, not only because of the importance we place on our breasts, but because our bosom is also where our heart is, where so much emotion is stored and felt – as though our chests needed any more pressure placed on them. For all the feminist ranting about the over-sexualisation of breasts, the truth is that our boobs are more than just utilitarian objects designed to feed babies.

We are destined to have a dysfunctional relationship with our breasts. From the minute our chests begin to fill out, or even more awkwardly don’t, they are an undeniable sign of our burgeoning sexuality that is visible to the rest of the world. We are judged on them, and judge ourselves on them, from the minute they appear. The other things that come with puberty, like pubic hair and menstruation aren’t readily available for viewing (well, you’d hope not), but our breasts? We have no control over them. They force us to confront our body’s development in comparison to our peers, and often they’re the cause of some pretty soul destroying taunts as we negotiate adolescence. Some of us are lucky enough to get through it all and end up happy with what we’ve got mammary-wise. Some of us get there via push up bras and cosmetic surgery. Some of us never learn to love our breasts at all. And for an increasing number of us, we wade through all that only to have our breasts betray us and develop life threatening tumours anyway.

It’s a lonely journey, cancer. Much as she has many people there for her, no one is really there with my friend. I don’t know exactly how bad the post-surgical pain was, although her tears gave me some idea; I didn’t know exactly how rattled she was by the diagnosis, although I could sense it in her text messages and emails and every black-humoured remark. I didn’t know how scared she was of what the future held, although I could guess. I was scared for her too. And I may have been alongside her in the hospital for part of it, but only one of us was the patient.

I sat in a scanning room in Nuclear Medicine, arguably the grimmest part of any hospital, while she had radioactive fluid injected into her nipple by a doctor she’d met only minutes before, the same doctor who was at pains to make sure it was okay I be in the room lest I get a nipple flash – as though there’s something awkward about a friend seeing your boobs, but not a bunch of medical staff. The room, at once high tech and 1960s retro, was a bit like the set of The Thunderbirds. The off-grey walls and floors and harsh lighting only added to the alienation. I watched her being slid into the PET scanner, manoeuvred and bossed around by staff who go through it too many times a day, saw them tape her breasts and draw guides for the surgeon on her skin in Nikko pen. I kept wanting to say “you know that’s a person there, right?” as they joked amongst themselves and worked out where to put the markings. It was all I could do not to reach out and grab her hand, give her some form of human contact amongst all the science fiction.

And yet I saw some of the sweetest moments of humanity in that hospital too. Fleeting connections between strangers that made all the difference to both of them – whether between the staff and patients, patients and their visitors, or between the patients themselves. There is an immediate level of intimacy created when people are brought together through illness. Maybe it’s just because someone else knows how bad the hospital food is, but it’s a connection nonetheless.

The fatalist in me says that breasts are just breasts – who cares if they go? And actually, I do believe that. Having a killer rack suddenly takes on a whole new meaning when there’s a Grade 3 malignant tumour nestled in your cleavage. If they’re out to kill you, then get rid of them. It’s not like your personality is stored in your mammary glands.

But I still have my breasts intact, and I don’t know what it’s like to mourn their loss. Another patient, full of good intentions, said that it’s better to be safe than sorry. She was right, of course, but my friend’s response “I’m both” was gut-wrenching.  It doesn’t matter how many times a woman is told she’s sexy, there’s a part of her that fears being undesirable. So imagine the psyche of a woman battling the combined effects of chemotherapy – the disappearance of distinguishing features like eyebrows, eyelashes and hair; the nosebleeds, blistered skin, lethargy, nausea, weight gain (or loss depending on the person) – along with the crippling depression that is both a symptom and a result of treatment, and whose scars across her chest continue to pull and hurt and send phantom pains shooting from the nerve endings where her nipples used to be. Can you imagine the strength it takes just to get out of bed some days, let alone out the front door? Seeing someone who oozes self-confidence be so vulnerable is heartbreaking. This should not be happening to her.

And yet, why not her? That’s the nature of this stupid thing. It doesn’t give a shit that she’s fought enough already to be here. Cancer is completely indiscriminate in its selection process. It’s never cared about any of the people I know who’ve answered that knock on life’s door.

I simply can’t fathom how anyone copes with being told they have cancer. It’s terrifying enough as a friend to hear words like tumour, mastectomy and chemotherapy. To be able to remain a functioning member of society when you are at your most fragile; when control of your life has been taken from you and put in the hands of a stranger now known as your oncologist; when dealing with the shock and fear and disbelief at how quickly life exploded has turned your brain to mush and left you unsure of every decision you make; when you can deal with it all with humour; when you can maintain some semblance of life despite all that, and when you can come out the other end never once having asked “why me?” while knowing there’s still so much ahead to get through…well frankly, that’s where my words run out.

And so, my love affair with breasts has hit a rocky patch. I still think they’re lovely, but I now view them the way I view a potentially dangerous dog. I’m happy to play with them, but I expect them to attack.

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Unavailable Tampon Syndrome

It’s two days before my period is due and as usual my mood is hanging somewhere between moderately frustrated and thoroughly homicidal. This month however it’s not PMT that’s the cause of my irritation, but another lesser known disorder called Unavailable Tampon Syndrome, or UTS. Most of you won’t have heard of it because…well…I just made it up, but the seriousness of the condition should not be underestimated.

UTS occurs when the only pharmacy you’ve found within a 20km radius that sells the only tampons you can use decides not to stock them any longer. Some lucky women may never suffer this affliction, and others may only have to confront it once or twice in their life, but if you’re anything like me you come to anticipate it on a monthly basis along with all the other joys of menstruation.

In my case UTS is caused by the increasing difficulty in finding stockists of Tampax Super Plus tampons (and yes I know that just gave you more information about my menstrual cycle than you were hoping for, but I promise whatever you’re imagining isn’t as bad as the reality often is. I hope that makes you feel better). For the last three years I’ve been UTS free as my local pharmacy has always had a supply of Tampax Super Plus on hand, sitting on the shelf gathering dust until I trundle in with my abnormal uterine bleeding every four weeks.  

It had been going so well. Where the supermarkets and corner stores had failed me, I could always rely on this one chemist to carry them. Once a month, as soon as my tits began to feel like watermelons, I’d duck in for my usual 30 pack of Nurofen Plus and two boxes of Super Plus. I’d go home, drug up, plug up and spend the next four days contemplating a hysterectomy. Too easy.

Yesterday all that changed. Standing in the feminine hygiene aisle desperately scanning the shelves, I felt myself relapsing. There were regular tampons, super tampons and light tampons (pfft, who uses those?!) There were organic cotton, fluro wrapped and easy twist open tampons. There were even slim ones, which I guess is good if the other styles make you look fat. But nowhere to be seen were the Tampax Super Plus tampons. Even worse, there wasn’t a space on the shelf where they should have been.  I knew where this was leading. Unavailable Tampon Syndrome.

Obviously my stunned expression was noted by the staff, because I was soon asked if I needed help. “Where are the Tampax Super Plus?” I asked in a way that I hoped disguised my alarm. “Oh, they’ve been discontinued by the manufacturer” said the guy serving me, a gay boy I know socially but not well enough for us to be totally relaxed discussing heavy periods. He was no doubt wishing he’d taken more notice of where I was standing when he offered his assistance, and desperate to cease discussing sanitary protection immediately. Clocking my look of disbelief, he followed up with “that’s solid information.” He was trying to act like he cared, but the curled lip and backwards step he took upon realising he was discussing things of a menstrual nature betrayed him, and I’m pretty sure as soon as I left he was texting all his friends about how close he came to actually having to deal with a period. Apparently there are some aspects of being a woman that even the campest man just doesn’t want to embrace. When he asked why I couldn’t just use the Super tampons I decided it was easier to leave than go in to the finer details of my flow with him, and frankly I was ready to suffocate him with a packet of overnight pads anyhow.  

In a total flap, I went home and panic bought $157.00 worth of tampons online from the only website I could find that had them in stock, and paid an additional $20.00 for urgent delivery. I know this seems like over reacting but panic buying before disasters is human nature, and trust me when I say that the 2011 Brisbane floods have nothing on the sort of flooding that can occur from my beaver dam. Eventually I contacted Proctor & Gamble to ask them for clarification, and received a reply assuring me that Tampax Super Plus were most definitely still being manufactured. I bloody well knew it.

I am not trying to be difficult, but to have to beg pharmacies to stock something that is essential is annoying at best. To be lied to about why they’re not stocking them is downright insulting. I don’t choose to buy Tampax Super Plus tampons because I get off on buying the biggest, most expensive tampon available; I have a medical condition that requires them. Of course I’d prefer to use the pretty little bullet shaped ones everyone stocks because they’re compact and easily hidden and come in bright colours, and I can buy the fucking things everywhere including petrol stations. Unfortunately, that is not how my body works.

I understand that Super Plus tampons will never be the bestselling item in the Tampax range, not every gal can be lucky enough to experience the sheer joy of a heavy period. But that doesn’t mean the women who require them cease to exist. And the most frustrating part of all of this isn’t the fact that they are so hard to buy. It is that on almost every occasion where I’ve enquired whether a pharmacy stocks them, a female assistant has said to me she would buy them too but she didn’t know they existed. It makes me wonder just how well Super Plus tampons would sell if women knew they were an option. Perhaps it’s time for the chemists of Australia to consider that a full range of tampons is slightly more important than a full range of Revlon nail polish?

As for the guy who told me they’d been discontinued? I can’t wait to drop a Tampax Super Plus in his drink next time I see him out. Just wait until he sees how much liquid those suckers can hold!

 

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Chinks In the Armour

Sometimes I feel like I’m the only lesbian who doesn’t fancy Ruby Rose. I know we’re all supposed to love a heavily tattooed, spikey-haired lezzer with a bit of talent and a lot of fame, but that’s never been my bag. This week though, I could have French-kissed the bejesus out of her. Talking about her battle with depression was a very courageous way to get my attention, certainly more effective than flashing her tits in FHM a few years ago.

I’m not normally a big fan of public emoting. I’m not even really a fan of writing about my emotions directly, I’d rather let them weave into my work organically than state implicitly ‘this is me’, yet in December last year I stood in line at my local Coles and burst into a very public bout of uncontrollable tears. Not the sort of tantrum brought about by long queues and a shortage of cranberry sauce that’s acceptable at Christmas time, but a silent overflow of tears that hurt my throat, and crushed my chest.

I had noticed the girl in front of me was covered with scars. Long, purple lines covered her forearms in a crosshatched mess of pain, and one angry, red one travelled from somewhere under her skirt, down to her knee. I’d seen similar scars before – on a friend, on the guy who works in the Night Owl – but I’d always been dismissive of them, waving them off with a reaction that was more ‘you hopeless emo’ than ‘you poor thing’. I never understood what would possess anyone to cut themselves up, why they’d want to do that to themselves. Recognising myself in her scars definitely wasn’t in the plan.

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I had been in a fog since morning, drifting from one task to the next, just getting done what needed doing. I was going through a very confusing break up at the time, one that had taken me so by surprise I simply couldn’t get past the shock to even deal with it. I was doing what I always do in those situations, which is to get up and get on with it and try to live around the hurt. I had to get up and get on with it. I run a business that employs people who are dependent on me for their livelihoods, so I did my best to ignore how I was feeling. I knew I was pretty drained emotionally, but it took a stranger with distressingly visible signs of pain to show me just how much I was hurting under my own skin.

Given my state of mind back then, my meltdown wasn’t a complete surprise. I hadn’t expected it to come to a head quite so spectacularly and in such a public location though. The strength of my reaction frightened me. I was so embarrassed by how pathetic I must have seemed that I went into hiding. I curled up on the couch and stayed there for two full days. I called in sick to work, and ignored phone calls. I replied to text messages only if I absolutely had to. And until last week, I didn’t tell anyone about it.

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It’s hard for me to write about this period without it sounding dramatic, which means it’s hard for me to write about it full stop. I don’t do drama, I prefer to keep things light. 2012 was a bust, horrible from beginning to end. It was like living through twelve months of sensationalist tabloid headlines – relationship breakdowns, financial dramas, family stresses, more relationship breakdowns, business and staffing problems, best friends dating exes, exes dating other exes, housing problems, health issues. I was New Idea, Woman’s Day and Who Weekly all rolled into one tattered publication. At the time I brushed everything off with “It could be worse, it’s not cancer” because I was trying to keep some perspective, but if the best you can say about a period of time is that at least no one you love died it’s not saying much, is it?

By the end of the year I was a mess. My hands shook all the time, I couldn’t sleep, I was drinking more than I ever had (which on this occasion IS saying much), I wasn’t eating, and I would cry at the drop of a hat. I couldn’t believe I’d become that person – the one with the continual dramas about nothing. I was under a lot of pressure to be okay, from myself and others. I was aware of friends going through far more traumatic events. Yet the truth was that, despite telling myself it could be worse, I couldn’t actually have felt any worse.

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The best indication that all was not well in my brain was that I couldn’t write. For the very first time in my life, I had no words. Deadlines came and went without me acknowledging them, story ideas dried up, I didn’t have a creative atom in my body. Writing is my outlet, but it’s only therapeutic when you can actually get the nonsense in your head out. And shitty heartbreak prose isn’t my style anyway. Thank god I can’t paint; my apartment would have been overflowing with huge canvases, painted black and pierced with stab marks. Nice, very postmodern. I was trapped inside myself.

I walked for hours every day trying to clear my head, but when I need to get away from my thoughts the very worst thing I can do is walk. Walking time is thinking time for me, and I was sending myself mad. Sleeping didn’t help either, because there was pressure for it to be a relief from the pain, and consequently gave no real rest. I would sleep knowing I was only going to wake up and feel awful again. I wanted it over. I know that my love for my parents meant I would never have thrown myself off the Story Bridge, but I honestly thought about it every single day.

I needed something to show for the pain I was feeling. That’s why the girl in the supermarket upset me. I could see that she once felt that way too, that her scars were something tangible, and that causing herself physical pain had given focus to her internal pain. That I understood even a fraction of what made her do that to herself scared the hell out of me.

Friends began to worry about me. I could tell they were discussing it whenever I wasn’t around. Eventually one suggested that it might be time to engage a professional. I listened, and made an appointment with my GP. She confirmed what I’d begun to suspect – that I was in the middle of a full emotional breakdown and diagnosed me with depression. Having no desire to become a totally mournful bitch, I got over my distrust of psychoanalysis, found a therapist I liked, and began to regain control of myself. I also went on a high dose of happy pills.

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Antidepressants have been my liberator. I don’t want to be on them forever, but at a time when I had little control over my behaviour, they acted like emotional Botox and gave me a break from the black emptiness I was feeling. I’d want to cry, but I just couldn’t. Eventually my brain gave up trying, and gave being happy a go instead. The clarity allowed me to focus on the real issues.

At this point, I really need to acknowledge how lucky I am to have amazing friends around me. And by lucky, I mean seriously lucky. I have an incredible pack of loyal and loving supporters who never once judged any of my behaviour during this period (well maybe they did, but they didn’t let on), and who made a point of being there for me without condition. I honestly don’t know how people get through life without a close posse around them. Streisand was right; people who need people are the luckiest people in the world. It might have been a miserable way to learn how loved I am, but I’m glad to know it now.

I also highly recommend removing whoever you need to from your life. Just tell them to fuck off. Seriously, use those words. You’ll feel better. Maybe that’s the best way to treat depression too. Get angry with it. I’m not saying it’s easy, but neither is removing people you care deeply about – even when you know it’s the right thing for yourself. The adage says that life wasn’t meant to be easy, but sometimes by doing what’s most difficult, life gets a whole lot less complicated.

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As for where I’m at now…I’m getting there. I still have days where I feel the emptiness coming back, but propelled forward by good friends, good drugs, tight family and a great therapist, I’ve started to see so much more ahead of me than the fog of sadness had hidden. I feel strong enough now to look beyond the protective wall those things have created. There are still a few chinks in my armour, but they’re being polished out. And I’m happy, albeit in a way that knows a price was paid for it. In fact, maybe it’s not happiness at all. Maybe relief is a better word – relief that I came through, that I can see I’ll be okay. Things are different now.

I felt so stupid for having such a seemingly irrational response to what was just another break up, and continuously asked myself the same question my mother did: “Why do you need therapy? Because you’ve let that <insert offensive description of my ex> make you feel bad?” But depression isn’t rational and it isn’t even so much about the catalyst for it. It’s about a genuine inability to lift out of feeling helpless and hopeless, and no one needs to feel stupid about that. We do though, and it stops us asking for help. That’s why I’ve chosen to write about the last five months. The more voices saying “me too”, the easier it will become.

One last thing. Nora Ephron once said the following:

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Print it out, stick it on your mirror. She knew her stuff.

By Caz.

International Endometriosis Week

This week is International Endometriosis Week, an issue very close to my heart. Well, actually it’s an issue close to my ovaries, fallopian tubes, uterus, bowel, kidneys and, according to the surgeon’s report, my Pouch of Douglas – whatever the hell that is.

For 13 years I was left to suffer the debilitating symptoms of Endometriosis as the condition went undiagnosed. From the first day of my second ever period, I began a way of living that was entirely based around my very unpredictable menstrual cycle.

Once a month, quite often twice, my entire life was brought to a screeching halt by the arrival of ‘The Period’. Its onset meant at least two days in bed with a migraine headache that no amount of medication would shift (although I never tried general anaesthetic – I suspect that may have worked), and at least three days of pain in my abdomen so intense that it caused nausea, vomiting, cold sweats, shaking, diarrhea and fainting, and required two Panadeine, two Nurofen and half a bottle of red to cope. It was all a bit Elizabeth Taylor, but at least the combination knocked me out for long enough that I could sleep through the worst of it. I then had a week of, and I’ll leave out the graphic details, extremely heavy bleeding which left me tired, anaemic and run down.

The rest of the month was spent getting more and more uptight about its return, whenever that may be. The erratic nature of my menstrual cycle meant I soon learned never to leave home without a large supply of Tampax Superplus, a few Nurofen & Panadeine, extra sanitary pads, and a spare pair of undies. Travelling filled me with angst. If I happened to be away from home, or unable to get home, the whole experience was humiliating for me and confusing for everyone else. How I could go from perfectly fine one minute, to an ashen grey, sweating, shaking, vomiting mess the next, was well beyond most people’s comprehension. Generally the reaction was to suspect me of ‘putting it on’. Once while travelling from Langkawi to Brisbane with a group of work colleagues I barely knew, my period unexpectedly turned up as we flew into Kuala Lumpur’s old airport. I was wearing white linen pants at the time – make your own conclusions there – and was left to sort myself out in a revolting public toilet in a decrepit airport in a primarily Muslim Asian country that didn’t freely sell sanitary protection, all the while experiencing a cold pain so strong it felt like a knife slicing through me. The only toilets available were of the squat variety, with the restroom attendant sporadically sending a burst of water from a fire hose under the stalls to clean the toilets out. Trust me, no one goes to that trouble for attention.

For years I tried doctor after doctor, sent from specialist to gynaecologist and back again, and was referred to many GPs who were apparently “amazing” with women. I was put on five different contraceptive pills, sent for three ultrasounds, given Wild Yam Cream, Evening Primrose Oil, organic tampons, had an operation to widen my hymen, prescribed copious packets of Ponstan, Naprosan, Naprogesic and Voltaren, boxes of Panadeine Forte, had acupuncture, Bowen Therapy and Electromagnetic Therapy, took magnesium supplements, iron tablets, ginger tea, special diets and applied heat packs. It was all a load of rubbish, and culminated in one doctor telling me that the best thing I could do was have a baby as that generally “sorted things out”. I was 15.

Finally, at the age of 26, I found a GP prepared to listen. When I met her, she was the President of the Australian Medical Association, and therefore had a few good contacts. One of them was an Ob/Gyn who was at the time President of both the Australian Federation of Medical Women and Medical Women’s International Association. My point in telling you this, and I do have one, is that this is the standard of doctor I had to find before getting a diagnosis. Within six months of meeting these women, I was essentially clear of the Endometriosis that had been festering inside me and causing me so much distress.

The thing that really irks me is that it took so long to get the correct diagnosis and treatment, and that it took two female doctors at the absolute pinnacle of the Australian medical profession to diagnose something as common as Endometriosis. Most women aren’t as lucky as I was to come across the level of expertise I found. After years of being sent for ultrasounds, I was told that Endometriosis rarely (as in never) shows up on those scans. That the only way to properly diagnose endometriosis is via laparoscopy.

This is pretty mundane stuff as medical problems go. It’s not like I was suffering from some weird African flesh eating virus no one had ever heard of. Endometriosis is a condition that affects approximately one in eight women, roughly the same as the rate of men suffering prostate cancer from what I’ve read. Granted, cancer kills, but quite frankly, so does a fragile mental state, and I most definitely had one of those by the end. Unbeknownst to me, I was also displaying classic symptoms of Premenstrual Dysphoric Disorder (PMDD), which is essentially like having an incredibly bad bout of PMT all month. Constantly in a state of high agitation, I was permanently moody, depressive, lacking confidence, lethargic and generally difficult to get along with. I had no sex drive, no motivation and no patience for anyone. My relationships with my family and partner were fractured. I am told it is common for women with Endometriosis to also have PMDD. If only I had known this sooner. Imagine how the people around me must have celebrated this secondary diagnosis – “Thank god they can give the bitch drugs!”

The doctors I spent years going to for help were completely ill-informed and ignorant to either of my conditions, something that only served to drag the whole frustrating experience out and make it even more upsetting. I’m not sure much has changed. And for this reason I say to any woman who suspects her menstrual problems won’t be solved by a cup of tea, a Bex and a good lie down:

Demand your doctor investigate fully. The majority of women have periods that only last a few days, and experience little or no pain. If you deviate from this, demand a laparoscopy. Take control of your health yourself. If you don’t feel you’re being listened to, demand they start paying attention, or change doctors. Just push and push until you feel satisfied that you truly have examined every single aspect of the problem. Your doctor may not take you seriously, that doesn’t mean you don’t have to. The immense feeling of having your life back, of being able to live spontaneously and free of the stress of Endometriosis is worth whatever was required to get you to that point.

And if anyone ever dares say to you, “C’mon love, take a Panadol and get on with it”, give them an uppercut. Actually, give them two.

If you would like more information on Endometriosis, go to http://www.endometriosis.org.au/