Tag Archives: medical

Snarling #12wbt: fitness, pregnancy and failure


There’s lots of inspiring posts by bloggers and feminist commentators on the web about the way pregnant women are monitored and socially controlled. Notions of success and failure as pregnant women (and as parents) are omnipresent and heavy to shoulder, and many of us uncritically and despite-our-critique internalize and suffer through them. If you’re a feminist who is or who has been pregnant you know what I’m talking about.

During our most recent appointment with the fertility doctor, I willingly (because I want to have a baby) entered into a space where no critique was off the table. My food intake, movement, use of substances like alcohol, sleep and weight were critiqued. Pretty painful and non evidence based statements about the relationship between weight and miscarriage were made (for the record, there is no link between being overweight and miscarriage although there is to being seriously underweight). I was told to make my body like “fertile ground for a baby to grow”. My male bodied partner was asked two questions and fleeting attention was given to his diet. It was all about how I might succeed or fail in my fertility and it was, almost 100 percent, about how that was squarely on me.

This is not really radical or harsh. It’s the norm. Women’s bodies, always under scrutiny, become even more pressured and framed as public property open for discussion (by family, co-workers, friends, doctors, strangers) when people become aware that you are trying to become or are pregnant. If you are already fat, people feel incredibly entitled to comment. Every mainstream book and article drips with judgement for fat bodies. And to resist this in any way is seen as irresponsible and un-motherly. People will give you props if you wholesale drink the koolaid, no questions asked. Be a good girl, be ashamed of your fat.

Here’s where it gets complicated for me. I want a natural birth as much as possible. I am very medically phobic and want to minimise the involvement of obstetricians and interventions in my birth journey. This means doing everything in my fucking power to avoid gestational diabetes, which pretty much boots you from the birthing centre. I am very, very worried about GD. Medically I’m in a “risk category” (we could talk for a long time about how these are used to frighten mostly women, and mostly women of colour regarding pregnancy).

I’m choosing to address my concerns by exercising and eating well but I have to wonder at how much GD is shaken like an angry fist of the gods (mostly by obstetricians, GPs and birth lit) rather than just put on the table as a necessary thing to negotiate much like fatigue and morning sickness. It’s a thing that bodies do, but unlike nausea and tiredness, GD is directly linked to weight and weight is an issue through which we can control women.

It features more thought, but the politics of pregnancy are pretty deep. I am privileged in that I have enough able bodiedness to avoid some of the worst of it, but I definitely get some blowback.

For some interesting reading about how fitness is a site of failure and success in fertility and pregnancy, you can always read Alice MacLachlan’s words over at Fit Is A Feminist Issue.


How you do it: navigating mental health services in NSW


*In this post, I am talking about experiencing mental illness/craziness/non-neurotypicality as someone who works within the medical model. I am not discarding the importance of the experiences of those who choose a different path. I am also using the word ‘crazy’ to self describe as it is shorter to type and is how I identify.

This is a rough guide to accessing crazy-services in NSW.

I’ve been diagnosed as crazy since I was 19 – almost ten years – so I’m at a point where I’d describe myself as an ‘old hand’ at navigating the NSW mental health care system.

I’ve never been admitted, so I can only speak about how to navigate services pre-admission.

WHO IS THIS FOR?

To the pre-diagnosis, or ‘pre-treatment’ crazy person, it can be overwhelming to try to understand how to go about getting help. It can be tiring when you’re already so tired, so ill, so worn down. Maybe you avoid seeking help because it all just feels too daunting. This is for you.

Quite possibly you don’t and won’t identify as someone with an ongoing health issue – you’re just having a rough time in your life and need some support while you get through it. This is for you too.

I am sorry you feel horrible. I hope this helps you feel better soon.

THE MOST IMPORTANT THING

Do NOT listen to friends or relatives or the media who tell you that the ‘system is fucked’ and there’s ‘no help out there’. This is actually bullshit.

The system is deeply flawed, but there are lots of (often free) services waiting for you. They are not perfect but the most important thing to remember is that they ARE there.

If you’re feeling unwell, it can be super easy to focus on all the pitfalls of any action you take. If you can, avoid thinking about how services will fail you before you’ve even started.

THE EARLY STEPS TO GETTING HELP 

If you are in crisis or immediate danger

If you are in crisis: (suicidal, extremely unwell to the point of being debilitated/dangerous to yourself or others or just not coping) contact your local Crisis Team. Each area in NSW has a Community Mental Health service, with an attached Crisis Team.

They will triage you (ask you questions to find out what treatment you need) over the phone, come to your house to check on you, send an ambulance to get you if necessary and also provide follow up care. There are links and numbers at the end of this post.

If in extreme danger to yourself or others call an ambulance – DIAL 000

If you are unwell but not in immediate danger  – welcome to your GP appointment!

If you are unwell but not in immediate crisis: make an appointment with a General Practitioner (GP) to get the ball rolling. Follow these steps.

Book a ‘long appointment’ with your doctor. The first time you make contact with your doctor will take a long time due to paperwork and their taking a ‘history’ of your condition.

If you feel extremely unwell/unable to articulate your needs and condition, take an advocate. This is a friend or family member who can chat to your doctor on your behalf, and provide moral support.

Tell your doctor ‘I am feeling unwell and I need to get help and make a mental health plan’. Make sure you fully describe your symptoms. Try not to leave things out because you are embarrassed. At this time, if you have wounds from self injury that need attention/stitches etc, ask your GP. They are more likely to be gentle with you than ER nurses/doctors.

What’s a mental health plan? This document includes a general description of your situation, and a path forward for treatment. THIS IS A VERY IMPORTANT DOCUMENT. You need the mental health plan to access monetary rebates from psychiatrists, psychologists etc and to keep track of your medication and how you are going.

Psychologists and psychiatrists and meds, oh my!

If you are very unwell and need to see a psychiatrist, your GP should find you one in the public system so it will be either free or less costly. If you need a psychiatrist appointment and your GP doesn’t offer to connect you with one, ask for this.

Psychiatrists are there to fiddle with medication and keep a very general track of your progress. Psychologists are there to help you discuss problems, issues and feelings and work on strategies to overcome them.

Your doctor will look up a psychologist for you in their database. This person will be recorded on your mental health plan. You can ask for one that is queer friendly, or a woman, or a person of colour and so on. This is your right. Ask for a psychologist who is within easy travel distance from you, if you are low on energy.

You pay for each psychologist session up front and get a substantial Medicare rebate back. You need to take your psychologist’s paper invoice into a physical Medicare office to get your rebate. There are a few psychologists who bulk bill, but they are quite rare.

Each appointment with a psychologist runs for about an hour. Try not to be late, because you will still be charged for the time, and psychologists are often quite busy. Ask your psychologist how much notice you need to give to cancel an appointment. Some will still charge you if you don’t give enough notice.

Your mental health care plan allows you six initial sessions with a rebate. Then, your psychologist has to send a letter to your GP reviewing your situation and saying if you need more sessions. At the moment you get another four, then another six after that. The number fluctuates based on changes made to Medicare at a state government level.

Your doctor will give you the psychologist’s number. If you feel unable to call to make an appointment, tell your doctor and they will do that for you. You can also ask your advocate to help you.

Your doctor will want to discuss medication options if appropriate. They may prescribe something for you. The ‘medical model’ is psychotherapy + medication = best general treatment approach. You do not have to take medication prescribed for you, but it may be in your best interests to do so, even if only short term.

Most psychiatric medications take about six weeks on average to ‘kick in’. Don’t expect to feel better after the first pill. It needs time to build up in your body and work.

You have the right to ask your doctor about side effects. Make sure you ask how to use it properly – how often to take it, if you can drink alcohol, if you need to drink extra water and so on.

Make sure you tell your doctor about any other medication you’re taking to avoid clashes with new medication, and to taper off any existing medication if you need to before starting this new one.

Once your mental plan is completed, you should receive a paper copy and your doctor keeps one on file. The mental health plan is usually reviewed once your Medicare allowed psychologist sessions expire.

Make sure you book in to see your GP about six weeks after starting new medication to check on how it is going and if is starting to work for you. You can discuss any problems you are having with it or request a medication change.

Now you should have:

  • access to a psychologist that should hopefully only cost you $40 an appointment or so after a rebate
  • access to a psychiatric appointment should you need it
  • access to some start up medication should you need it
  • access to crisis services should need them
  • a clue-by-four and less confusion!

IMPORTANT NUMBERS AND LINKS:


Hold Fast To Your Oar: death, fear and being an ally.


What do we live for, if it is not to make life less difficult for each other? – George Eliot

 

I met Alinta Thornton shortly after I moved to Sydney.

Sitting in the front section of Grub and Tucker on King Street, Newtown, her hair was a wicked red with pinkish highlights. She was drinking strong coffee and ordering cake. She said something sharp to the waiter – I couldn’t discern what – but it looked and sounded critical. The waiter scurried back soon after, humbled.

This is my first memory of Alinta, but not nearly my best. It does cast a shadow of her figure though, and all the beautiful elements that mingled there.

We’d been blogging friends for a year and a half. We bonded through a couple of different interests and soon became regular followers of each other’s often daily entries. She was a mother hen on the internet; she supplied advice that was full of weight and thought-out and sometimes terribly hard to take. But you knew she was right.

She was also a wit. Some of her observations were hilarious.

In fits and starts, I got to know her. We became close, and she observed as I navigated the new city with a mixture of success and oblivious failure. She face-palmed as I involved myself with the wrong people, and cheered as I worked out my miss-steps and got it right.

Alinta became like a big sister, an aunt, and a vicious teasing girlfriend all at once. She became a true mentor and very soon, her advice was that which I sought first and respected most. Her partner Julian became an ever closer ally too, and as time wound on we became good friends.

Now I wish that time hadn’t marched forth. I wish I’d snap frozen it the first time I met her, not allowed another moment to pass.

I knew Alinta was sick long before I met her. Her blog recorded the journey, the appointments, the horrible dreams.

Terminal breast cancer is something you really can only understand if you either have it, or are helping someone with it die. I’ve learned that you should never, ever say to someone with cancer “oh I know just how you feel, because my nan’s sister’s cousin’s aunt had a mole removed.” I’ve learned that unless you’re 100% sure that you’re living what that person is living – you should probably shut the fuck up.

There was a team of us with her, by the end. A round table of friends and lovers, headed by Julian, the ship’s captain who bore the vast majority of the burden (and the heaviest pull being felt now).

We were all pulling our oars one way: to comfort the lady, the lady we all loved. I participated in a small way; thrice weekly I came by to clean and serve meals and be around for chatter and comfort. We all came, mainly, to fill the house and be felt – I know I was desperate to bring some warmth to the chilly fear and anger and frustration that emanated from her. I know I didn’t succeed, and I’m not surprised. I am, after all, not able for that task because you can’t salve the knowledge of impending death.

And this brings me to the point of my point. My point is not that Alinta is gone and that I miss her, though these are good things to say. Nor is that she was magnificent and the world is poorer without her, though this too is true.

My point is that there are too many lies about death and dying. There is far, far too much lying about how we face our own extinction.

I hear people say all the time that their relative made their peace with death, or that one can be consoled by this or that. I hear people making a myriad of excuses that manifest as spiritual, philosophical and emotional mumbo jumbo that amount to little more than a heartfelt, avoidant and irritating lie.

The lie is that people who are aware that they dying are not scared. We, the living who watch them get eaten alive by diseases and syndromes and horrible, uncontrollable breakages of the body, really want to believe that they are not scared because their fear is big and palpable and confronting. This is why we make bullshit up, because it helps us cope.

Our lying is about us not them. This seems to be unbelievably selfish.

Alinta told me in no uncertain terms that she was terrified of death. She was absolutely packing it. She ranted and railed and wrote pages about her fear dreams. In them, her cancer took the shape of different people and did horrible things to her – tricked her, trapped her, put her in horrifying situations.  She wept, she screamed, she said NO to death in a loud and unhappy voice; very afraid. Alinta didn’t lie.

I’m not sure she was as scared, on the last day I saw her. But by then, my lady was drifting away from us already, not quite herself anymore. I ran home in the rain from St Vincent’s, barreling down Oxford st, my heart and throat all clogged and heavy and the rain and tears a singular muck.

Why, why is it so important that we stop lying about how utterly scary death is? If it brings us comfort, why stop?

I think it is important that we stop because our rhetoric and our fucking around with words that serve mostly to comfort ourselves are silencing the people who need us to be real, to be the most real we can be – because they don’t have much time.

They certainly don’t have enough time to bear up under our false platitudes, our falsely wise nods and smiles and crappy excuses in our impossible quest to settle their fevered emotions to a ‘safe’ modulation. They’re dealing with enough.

I feel that we need to be able to look the anguish of someone’s pants-pissing terror in the face, to see that the face is our mother’s or brother’s or lover’s own face, and hold their hand and be with them in that moment. It is bold and humane and loving and right to grasp someone and be in that with them.

I can’t bear to provide some incentive, some quaint little insight we may gain from this. A lesson, or a cute koan that is our cookie for being present in the moments of fear, the days of fear, the weeks and months and years of fear with someone who is dying.

Here’s the point now, the whole. damn. point :

When you’re beside a being whose earthly existence is about to truncate, it ceases to even remotely be about you. You have become the ferryman  and the dark ride you are taking is most assuredly across the Styx. You are watching them go to oblivion.

The gift you give by holding fast to your oar is the very small, but I hope precious feeling of the warmth of another person’s hand while the most shattering woe imaginable sweeps through someone. Can you imagine? Nothing can avert the danger. Imagine the panic, the sledgehammer screaming towards them.

It doesn’t seem so hard then, to cut a few permanent holes in your living fabric to make room for the pain of another.

To make it a little less difficult, even if only for the space of the drop of a heart beat.

In memory of Alinta Thornton. Missed, every day.


%d bloggers like this: