Sunday, 4 May 2014

Patriarchy, we need to talk about vulval itching

Inspired by Jeanette Winterson’s Guardian article, Can You Stop The Menopause?

I am writing this while pissing Samurai swords. When not pissing swords I’m managing to piss shards of broken mirror, whole arrows complete with tips and ends, crumbled chunks of pebbledash and the occasional streak of razor wire. When not doing that I’m taking as many cranberry tablets as I can fit in my mouth and drinking pints of nettle tea, dandelion tea or cold water with bicarbonate of soda mixed in. 

I have cystitis, obviously. Very common, very discomfiting. It occurs, or threatens to, whenever I’m dehydrated. The last serious attack before now was at the end of 2012 when I had a glass of vinegary red wine in a restaurant and went to bed without needing the bathroom. By the next morning my bladder had filled with crunched glass. 

The 2012 cystitis attack and the health issues that followed have made me think about the connection between external events and internal manifestations, mental pain causing physical pain, the mirroring of psychology and physiology. It also shone a light on some GPs’ apparent ignorance of this connection. I had never got cystitis just from one glass of wine and a missed bathroom visit before, but certain events I experienced had clearly weakened me, worsening my susceptibility to illness, the frequency of illness and the severity of illness. They left behind a trace of vulnerability operating at a very deep level. 

I went to the GP to get some antibiotics for the cystitis. She gave me a five day course of something so strong that it gave me thrush. I’d never had thrush before and assumed that the antibiotics hadn’t worked and that my cystitis had worsened. I went back to the clinic and was assigned a (very nice) man I’d never seen before. 

“I was wondering if it might be thrush?” I said in passing.
“Do you have any discharge ‘down there’?” he asked, looking embarrassed.
“No.” There was just an extreme discomfort, tenderness, soreness and swelling and a sense of tingling, weeping, sizzling allergy, as though the skin had suddenly become live.
“Then you don’t,” he said with relief and gave me a further three day course of cystitis antibiotics despite there being “no blood, no proteins,” in my urine.

Secret hint to gentleman GPs: if you’re calling it “down there” while exuding very strong aversion vibes to actually looking “down there”, you may be in the wrong profession. The antibiotics sent the thrush over the edge and led to extreme discomfort and feverishness for six weeks. It was so bad that in the middle of a voiceover recording a colleague said to me in concern, “I can tell that something’s not right.”

Like so many women facing dismissal of our instincts, derision for our opinions, contempt for our knowledge and aversion for our bodies, I got the correct advice from other women. Discharge doesn’t always happen with thrush, which has a range of symptoms. A colleague who’d been hospitalised for long stretches was told privately by her nurse that antibiotics often caused thrush through their brutal destruction of the good bacteria in the gut alongside the bad. She recommended taking probiotics and probiotic yoghurt. Various women’s health forums suggested topical and natural remedies – natural yoghurt again, a heavily diluted tea tree oil solution, garlic or swallowed garlic capsules – all of which worked to ease symptoms. Then there’s the anti-thrush diet which many women said had permanently cured them. Zero sugar, zero carbs, no booze, no caffeine. Booze and caffeine to be reintroduced in small amounts a couple of months later. 

I tried it. It stopped the thrush dead within three hours. 

How can GPs not know about these simple, natural solutions? I’m not talking about flower remedies, homeopathic pills, exotic herb concoctions or casting spells at the full moon, just basic changes to diet and the topical application of ingredients with known antifungal and antibacterial properties. How can GPs not know the full range of symptoms of something as common as thrush? How can they be so cavalier about prescribing antiobitics which have such a strong effect?

The next time I went to the doctors was for a routine smear test and met lovely Dr Newman.

“They really need to redesign these things,” I commented dryly, in so many ways, when it was all going on with the duck (my term for a speculum).
“And it’ll be a woman that does it, I’ll tell you that,” she said.

Love a flash of feminism in a medical professional. I told her about the thrush and instead of throwing pills at me she told me not to take antibiotics as it would just make me resistant and instead to drink as much water as possible to flush it out. Although she did make a little racial error when recommending a follow-up health check to my mother. My mother was about to go to India and suggested that Dr Newman give her a letter to take to a doctor there.
“It does need to be someone who speaks English,” said Dr Newman. 

Dr Newman, some tiny tips. India’s doctors all speak fluent English and usually at least two other languages besides; India’s medical expertise is so great that Indian doctors and surgeons are employed globally and are indeed famous for their skill; and India’s best hospitals and specialist research units are world class. You seem to be under the impression that we are about to go to a village health station under a palm thatch in the middle of nowhere to talk to a shaman holding a feather and a rusty shaving blade. We are not. 

Incidentally the worst/best place I was ever recognised was in the middle of a smear test, by yet another doctor at my local health centre where morale is obviously so low that they change their entire workforce about twice a week.
“Haven’t I seen you on TV?” said the woman.
*Insert duck.*
*Open duck*
“Yup. Maybe,” I stiffly conceded.

Anyway, I sorted it out. But in the long run I’ve found it disturbing that my usually equine constitution has become so sensitised. The thrush flared up again last Christmas after a few mince pies too many. This was exceptional: I don’t usually eat sugar or major carbs but certainly never worried when faced with the odd plate of pasta, a dessert or a cup of coffee.

I am struck by the years of crumbling physical damage caused to me by an injury that was emotional and psychological: the thinning hair (which I write about, with handy remedies, here); the nagging stress acne which never quite goes; the way a simple cold now becomes five days of bed-ridden temperature; the loss of muscle mass; the terrible triggering, which I describe here. I am literally weaker than I was before, unable to run as far, lift as much, build as much bulk or work out as intensely as I used to.

Before, I had never understood people who claimed that non-physical issues like unemployment, over-work, being in the wrong job or experiencing a family dispute had ‘destroyed their health’. I thought the phrase was melodramatic, Western-privileged and narcissistic; people worldwide who survive natural disasters, famine, pandemics and wars do not go on about it ruining their health. They don’t have the luxury.

Having survived the last five years, I see now how it is possible. Instead of following GPs’ concentration on treating symptoms rather than causes, we must embrace an idea of total health, which does not make a stark distinction between the soul and the body and accepts that one affects the other. Emotional pain becomes physical pain while emotional strength boosts physical strength. Happiness, caused by social factors, supports numerous health factors.

I didn’t make the connection between the events and the effects until I went to get a verruca sorted out at the chiropodist.
“I got it from a shared hotel bathroom in New York. You see. Never travel cheap,” I said. I nodded down at my toe. “There’s loads of them. It’s like a mushroom forest.”
“It’s to do with your immune, you know,” said the woman.

That explained it in a flash. The colds, the hives, the zits, the thrush, the fatigue, the muscle turning to flab, the feeling of being dogged by weakness and ill health. It is sad that events from five years ago should have such deep effects as to disrupt and sicken the very fibres of my being so that bacteria, infection, disease and germs can drag me down. I feel defiled by what happened and this feeling is vindicated at an observable, cellular level.

When I think about what happened one image comes to mind: that of being struck at the core with an iron bar, straight through with one strike, of a strong and elegant column being broken into pieces by a stranger who came out of nowhere. And then being torn open, gutted, eviscerated, thrown away and left to die.

You cannot put a shattered column back together. You must accept its destruction, accept your own annihilation and the success of the destroyer. You must walk away from the debris and start again. It is sad that the rebuilding process is not just professional, not just emotional, not just social but must also be physical and carried out in the most gratingly basic way. And it bothers me that a person is able to do this to other human beings and thrive in success, social regard and happiness while his victims are demolished publicly, privately, psychologically and physically.


Further reading: