Categories
childhood disability faith family

A Letter to Caregivers

This is the first piece I wrote and had published on the internet. It was spring of 2018, I was living in Tulsa, and had entirely lost myself in religious community and the 10 hours of teaching I was doing every day and as such, felt like I had lost my ability to envision myself in the Church. I’m feeling pretty similarly, today.

I found so much solace in the letters being compiled at The Catholic Woman, a then-new online space for women to write letters to women who had had similar life experiences, encouraging them that there is space in the Church for their unique experiences and wisdom.

When considering the spaces I felt were lacking then, in 2018, and what I might contribute to this library of letters, I reflected back on the previous times in which I didn’t feel there was space for me in the Church, that doing so might enlighten where I could discover space amidst my then-present wanderings. I’m doing similarly, today.

I wrote my letter on disability. Specifically, disability caregiving. I had yet to go to graduate school. I hadn’t even decided where I would go! I hadn’t encountered secular Queer and Crip Theories about the body. I hadn’t jumped head-first into Christian disability theology. All I knew was my own experience as a caregiver of a sibling with profound cognitive and physical disabilities, and I was emboldened by the sliver of theology I had learned in undergrad. To be frank, I was at the peak of that pesky Dunning-Kruger bell curve (which I write about here.)

When I was growing up, not-belonging in Church (and in many other social spaces, like in stores and barbecues and friend groups) was almost entirely contingent upon Matthew not belonging. I didn’t feel comfortable at Mass because Matthew would be loud, people would stare, and he would potentially kick the paten out of the priest’s hands at Communion time, scattering Jesus across the floor to a chorus of gasps. When we moved, not belonging at Mass looked like not being able to fit his wheelchair into the old Church and down the aisle. There was no place for him to sit without taking him out of his wheelchair and wrestling him into the pew (which, with his behavioral difficulties, is not realistic.) At that early age of not-belonging, my youngest brother Michael was also young and impatient. At first he was a baby, crying and pooping and screaming and needing my mother’s comfort. At the later stages, he was whiny and insatiable and tantrum-ridden.

My perspective on all of this not-belonging was a place of young shame. Of immense responsibility as my mom’s primary caregiving support. Of anger that my dad was deployed or working or not wanting to come to Mass with us (though, he eventually came around and even ended up converting.) It was also my fledgling notice that disability was not welcomed in the Church, despite being present in so many Gospel messages of Christ healing the blind, deaf, and paralyzed. It was the beginnings of the fire that would be ignited about the hypocrisy of loving those on the margins while scoffing at them when they laughed loudly during the consecration because they found the tinkling of the bells enjoyable. It was the beginning of my questions about welcoming all to the table while not looking Matthew in the eye.

These were my first tastes of not-belonging at Church, and it was these moments that brought me solace in 2018 as I sat to write my letter. It was that not-belonging that I wanted to speak to.

As such, the title of my original Letter to Women was “Making Space for the Disabled.” It was meant as a riff on the lack of physical space made for Matthew and others like him, in so many situations, some of which I spoke to in the letter.

And it worked! I found a space for myself in writing and studying disability and Catholicism, a belonging I continue to lean into today. I went on to study it in graduate school. I pursued volunteer opportunities that would foster relationships with disabled persons. I wrote more about it on the internet. I combatted my not-belonging by writing about not-belonging.

But now, as I look back on the letter, as I attempt to house the sum total of my writing these last 3 years for various publications on this blog in some form or another, with the experience I’ve gained in my study and work and friendships, I can see that in some ways I was conflating the experience of the disabled person with the one giving them care. These experiences are not the same.

However, the experiences of giving care to a disabled family member are some of the most intimate you can get when not disabled yourself. You feel the stares, you recognize the inaccessibility of a space, you field the ignorant questions if your loved one is nonverbal, and you advocate on their behalf if their cognition limits their self-determination. This was, and in some ways still is, my experience.

I also recognize that some may bristle at the idea that I, as a sibling, would in some ways equate myself with other kinds of caregivers, whether they be parents or teachers or nurses or aides. I recognize that the ways my parents have given care supersede some of the ways I was required to give care (but it was a requirement, because of the relationship I had with my parents and siblings, even if others might view it as my choice to serve my family.) But as I learn more about being a sibling to disability, and as more and more siblings share their own stories online, I invite the patient consideration from both outside and internal voices that I did experience a comparable pressure and responsibility to give care that many don’t experience until they are the parents of their own children. That I did experience a comparable responsibility for another individual’s safety, health, nutrition, and happiness that draws me into conversation with similar responsibilities from various walks of life.

My experience of responsibility was then and remains today valid.

For these reasons, if I could go back, I think I’d change the title of my letter to what I’ve named it here: A Letter to Caregivers. Nowadays, I could write a different and better letter on what it would take to make space for disability for disability’s sake, and it would start by passing the mic to a disabled person and going from there. I still think my letter speaks to the heart of making space for disability, for the caregiver’s sake. For that reason I’m still proud to host my letter here. And it continues to prod me to write more here about what it was really like being a sibling to Matthew. (So more on that is coming soon.)

Here’s the opening of the letter, and I invite you to read the rest of it at The Catholic Woman:

Dear Family,

This ones for the caretakers. For the people who don’t buy white clothing because it’s just going to get dirty. 

My younger brother Matthew was born with Cri du Chat and DiGeorge Syndromes. Combined, these chromosomal mutations look a little like Cerebral Palsy, and a lot like cognitive delay, a compromised immune system, a pacemaker, a lack of consistent toilet use, and a love of crackers, cereal, and a good restaurant. 

I have always been involved with Matthew’s care. I have confronted the stares, the lack of a wheelchair ramp, and the soiled bedsheets alongside my parents and other younger brother Michael.

Lesson: Taking someone in a wheelchair to the movies requires two spaces. A space for the wheelchair, and a seat beside them…” To read the rest of the letter about how I LEARNED this lesson, click here.

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Categories
health PCOS

Supplements and Supports

So I’ve nearly bled to death. I’ve gotten on (and then off) the birth control pill. My period is gone and my gut is wrecked. What does past-Madison do next?

In this final installment of my PCOS series I am going to try and do two things:

  1. Walk you through what I’ve tried
  2. Repeat, over and over again, that I am not a doctor

Because two things can be true:

I almost exclusively came to the understanding of my potential health diagnoses through independent research, online resources, and trial and error.

And it is important to seek the insight of medical professionals anytime it is accessible for you to do so.

In the now-three years immediately following the complete collapse of my sense of health, I did not have access to my primary care physician, and my health insurance plan required her referral to see any specialists. It wasn’t until I finally saw a young, female doctor through the student health services at my graduate school that a medical professional confirmed for me, in-person, that I probably have PCOS and can get a period with proper non-birth-control mediation. But when we left off, I was sure that I had Post-Birth Control Syndrome (PBCS) and my period hadn’t come back. How did I get from that to a different but similar acronym?

In my prior post I talked about Dr. Jolene Brighten, whose website and resources popped up as I manically Googled “I just got off birth control and my body is destroyed.” After reading a bunch of her articles and participating in her free online conference on hormonal health, I paid for access to her “Birth Control Hormone Reset” course (it was $150 at the time.)

In this course, I was taught the ins and outs of my hormones and their cycling, and I was instructed to try a number of things. Some of them worked. Some of them might have worked. Some of them definitely did NOT work. That’s how I’ll organize them:

PBCS things that DEFINITELY worked:

  • Eating a whole food (or “paleo”) diet : For the first year I was off birth control and in Chicago, I ate as un-processed and un-packaged as I could. In part due to my neighborhood becoming a food desert one month into my residence, I began using Imperfect Produce* and designing my meals around veggies and fruits. I did not do this exclusively: I still ate pasta, rice, canned veggies, and fast food. I still ate at restaurants and had a cup of noodles when the school day ran me to the ground. I made cookies and brownies, and finally got in the habit of eating breakfast via Cheerios and instant oatmeal. Most important was that I tried AND that I did not count calories or restrict myself in any capacity. I just ordered fruit and veggies and knew I had to use them before they went bad. It’s still the most consistent cooking I’ve ever done in my life, and it drastically changed how I felt in my body, for the better. I will also say it loud-ish and proud-ish: I don’t eat this way anymore. I have far less time to cook, and I found in the middle of my shift from PBCS to PCOS diagnosis, I began to feel very self-conscious about my weight. I actively dieted for two months, watching my caloric and nutritional intake, and to nobody’s surprise felt so much worse about myself. So I stopped. And I’ve been letting myself eat whatever sounds good since, because COVID. The last thing your body needs during an excruciatingly stressful time is to count calories. Sure, I’ve swung the opposite direction now, back to not getting enough fruits and veggies. But I’m getting back on the horse! (* This link is my referral link. If you use it to sign up, you get $80 in the form of $20 off 4 consecutive boxes. And I get $30 off my next box. Just call me a veggie influencer I guess.)
  • Cutting back on dairy: I grew up in a house where we had at least one if not more glasses of 1-2% dairy milk with dinner every night, so I’m LOVING the “got milk?” memes about the hold the dairy industry had on our generation. The rise in alternative milks has been life-saving for someone with a sensitive stomach, constipation, hormone issues, and terrible acne. Cutting back on dairy is the #1 thing that has revolutionized my skin and made my stomach far less nauseous and irritated. For those who are curious about the most eco-and-hormone-friendly alternative milk options? Oat milk and flax milk. Oat milk is now so widely accessible it’s surpassed almond milk in popularity. Flax milk’s taste is hit or miss, so I go with oat 100% of the time.
  • Eating MORE: People with hormonal imbalances often gain weight uncontrollably. With the hold diet culture has on us, it should come as no surprise that many women under-eat in response. Under-eating increases insulin sensitivity, increase stress hormones, and increase fat production as your body produces and stores what it needs to survive. Eat when you are hungry.
  • Pelvic floor exercises (and peeing more regularly): As is the case with many women who undergo any type of hormone supplementation, my pelvic muscles and bladder control dramatically decreased during my time on the birth control pill. Once, I had to walk home four blocks from a bar where I’d had 2 beers. In the 10 minutes between the bar and my apartment, without even a full bladder, I couldn’t hold my urine. In the hallway out front my door, I completely wet myself (and then had to explain it through embarrassed tears to my roommate.) I share this because it’s not talked about, even though it still brings up feelings of shame. Incontinence happens, and is tied up in our hormones. There is not much you can do about it beyond pelvic muscle exercises, and going to the bathroom as frequently as you need to avoid urgency.
  • Getting more sleep: This was hard in a cockroach-infested apartment in a city. But I tried to set aside 8-10 hours every night for sleep. I needed it. And I stuck to it. (Except for on paper-writing or exam nights…) Your body needs to rest to heal. Period. I know it’s not realistic for everyone, especially for mothers with small children, but I can’t stress enough how constantly fatigued I was after my digestive illness. I couldn’t heal without sleep.
  • Drinking more water: Grad school and illness finally did it to me. I FINALLY got — and actually USED — a water bottle. It’s amazing how quickly you can go from feeling like you’re dying to remembering that life is worth living by drinking a glass of water.

PBCS things that MAYBE worked? (Maybe it’s the placebo effect?)

  • Collagen Powder: I began taking Vital Proteins, mixing it into baked goods and beverages, because I won a giant container in an Instagram giveaway. That’s the truth. But as I looked into it, I found some feedback that suggested not only that it was good for skin, nails, and hair, but that collagen is crucial to a healthy stomach and colon lining. I will say, I experienced far fewer pinching and burning feelings that had previously accompanied my mild ulcerative colitis. But who knows: It could also be attributed to the other things I did. Collagen powder is still a great way to incorporate protein into your diet, regardless.
  • Drinking tea: I began drinking a cup of tea every morning and every evening. A number of herbal teas had been recommended to me during my illnesses (ginger, green, peppermint, hibiscus, raspberry leaf, and dandelion root being the key players.) With my sensitive stomach lining, I began avoiding peppermint because it’s an irritant. The others I alternated. The most helpful for me seemed to be ginger (I bought THIS probiotic kind from Celestial Seasonings) and green. Word to the wise: Green tea makes me bloated and burp-y. Not sure why. But I did find my stomach soothed and repaired after making tea a habit. Maybe it’s nothing more than drinking more water, but it can’t hurt!
  • Supplements: I’ve tried so many, with mixed and unclear results. If my general trajectory indicates their success, I’d say give them a try. But I cannot trace any particular result to any particular supplement.
    • Dr. Brighten’s Balance: This is the supplement I’ve taken most consistently. I didn’t notice any significant changes until I started my prescription to induce a period (we’ll discuss momentarily.) I find my PMS, headache, muscle ache, and cramping symptoms associated with my cycle are far less brutal taking this supplement.
    • Dr. Brighten’s Adrenal Support: I took this for about a year, to combat constant feelings of tired-upon-waking. It seems to have helped.
    • Dr. Brighten’s Adrenal Calm: I take it like melatonin in the evenings if I’m wired, traveling, or haven’t been sleeping well.
    • Whole food multivitamin: Certainly helped me fill some gaps in my diet, but I found them very difficult to digest. If I didn’t eat a large meal with each pill, I would experience severe stomach pain and bloating.
    • N-Acetyl Cysteine: Amino acid that is supposed to aid in production and absorption of glutathione, a key player in the balancing of hormones. Who knows if it’s doing anything.
    • Vitex: Also known as chaste tree, vitex is meant to help cycle progesterone. Since it’s found in Dr. Brighten’s Balance blend, I don’t take it unless I run out of Balance.
    • Spore-form probiotic: This is the kind of probiotic Dr. Brighten and others recommend, especially for those with leaky gut or other digestive issues. Probiotics in spore form have a better chance of surviving the journey to the center of the gut. I didn’t notice any difference in success compared to a regular probiotic.
  • Castor Oil Packs: A number of online hormone healers recommend taking up the practice of castor oil packs for liver and gallbladder soothing as well as pelvic detoxification. You soak a flannel or cotton rag in castor oil, place it directly on your skin, and then put a hot water bottle on top of that. I think any and all positive benefits I experienced could just be attributed to the benefits of a soothing hot water bottle. Who knows if the castor oil is anything more than a woo woo fluke. But I tried it! And it seemed to help in the midst of gallbladder spams and abdominal cramps.
  • Yoga (and otherwise not working out): I have always loved yoga. I pop into the classes my mom takes every time I go home. I made good use of the free yoga classes for students during grad school. I sometimes did self-directed yoga at home or in the park. I feel strong and soft and peaceful when I do yoga. I can only imagine this helped. Otherwise, working out really stresses me. I don’t find it fun. Doing high intensity workouts increase stress hormones and the soreness and inflammation of the muscles can be difficult for me to navigate on top of digestive and reproductive pain. So besides yoga, I didn’t do any other physical activity.
  • Kombucha (and other fermented things!): Dr. Brighten suggested fermented foods to aid in digestion and repopulate your stomach microbiome, which is often depleted from consistent birth control usage. I had never tried kombucha before trying her protocol, but I fell in love with it. Unfortunately, they stopped making my favorite kind and I’ve since given up the habit (@ Health Ade: Bring back your Original flavor. Please and thank you.) But I still snack on pickled ginger that I request in bulk from my local sushi place.

PBCS things that did NOT work:

  • Cutting out coffee: Lots of people online, especially those with anxiety, suggest cutting out coffee to reduce the production of cortisol, our stress hormone. I’ll admit it: Coffee can make me feel jittery and anxious. Especially if I have it on an empty stomach. But I cut out coffee entirely for three months during this protocol and did not experience a single bit of a decrease to my anxiety. I didn’t experience a natural boost in energy after the withdrawal symptoms subsided. I didn’t experience any increase in mood. When I brought coffee back, I didn’t experience any symptoms either. It seems coffee doesn’t do all that much to me, so long as I eat. And I enjoy the taste so much, I’m keeping it around!
  • Prebiotics: With the gut dysbiosis that comes from being on birth control, everyone and their mother suggests a probiotic. That, I can do. But so may probiotics now come with PREbiotics, which are meant to feed the probiotics to keep them alive and well in the journey to the center of the gut. Every prebiotic I’ve ever taken has made me so bloated and uncomfortable, it just isn’t worth it. I’ll stick to my pickled ginger, thanks.
  • Seed Cycling: The woo woo spouse to castor oil packs is seed cycling. During the first half of your cycle, you crush and eat two specific kinds of seeds. During the back half of your cycle, you crush and eat another two types of seeds. The nutrients in these seeds are meant to mimic the release and rise of the various female hormones. I tried it for three months and felt so silly, and felt so little of a difference other than increased stress having to figure out how to incorporate sesame seeds into my every day for two weeks straight, it just didn’t seem worth it. Maybe it works, but it’s too much prep for me.
  • Dr. Brighten’s food protocol: It’s important to consider the ways that, had I not been in dialogue with gastrointestinal medical professionals the year prior, I might not have recognized the risks of following her protocol to a T. Her dietary protocol is devoid of processed carbs and dairy and heavy on fat and cruciferous vegetables. This is, in part, because these foods are high in nutrients your body is naturally depleted from due to the birth control pill. However, these are exactly the same foods that populate my “gallbladder no-go list”: They are extremely difficult to digest. Ultimately, I couldn’t follow her meal plan without posing myself some serious risks. I also found that participating in her online Facebook group form was not helpful for me: None of the women could relate to these health risks posed by the diet. And when I proffered my difficulties, the moderators had little more to say than, “just stick with it!”

I’ve written for The Young Catholic Woman an article on online influencer courses and the dangers of investing time and money into someone who doesn’t personally know you. I can confirm that Dr. Brighten’s protocols were an absolutely pivotal catapult into the world of menstrual and hormonal health. Absolutely irreplaceable. But my feelings might have been different if I didn’t have the insight of other medical professionals also in my back pocket. All this to say: Please be careful. “Doing your own research” doesn’t mean “stop looking after the first aesthetically pleasing doctor with an online presence.” It means looking into numerous opinions. And remember that these thoughts in these lists are my own, personal experience. I AM NOT A DOCTOR.

One of the people Dr. Brighten herself directs her clients to for additional insight is Dr. Lara Briden, author of the Period Repair Manual. I read this book cover to cover and began to compare what I was reading there with what I had read from Dr. Brighten. It became clear to me that, what with my period not coming back after a year of following Dr. Brighten’s protocols, something else might be awry. One year is definitely enough time to cleanse your body of artificial hormones and restore depleted nutrients. It began to seem like my hormones were cycling, but I wasn’t ovulating. This led me to begin researching PCOS. The symptoms Dr. Briden included in her book’s examination into Poly-Cystic Ovarian Syndrome (PCOS) were compelling. Many of the symptoms of PCOS and PBCS are similar, but there are a couple of key differences. The biggest two? Insulin resistance and uncontrollable weight gain.

Since coming off of the birth control pill, I had not experienced any weight loss, despite having gained it so suddenly and immediately upon starting the pill. I was eating healthy and getting good sleep. But the weight kept piling on. Additionally, I was noticing that my sensitivity to sugar (which I briefly discussed in the Birth Control installment) was getting worse. My stomach was immediately upset after eating sugar. I would get fatigued and bloated, with brain fog to boot. I was also showing symptoms of male-pattern hair growth. So, at the same time that I was exploring Dr. Briden’s PCOS information, I began to see a doctor through school.

This was the doctor that finally ordered my first ever blood work for a comprehensive hormone panel. The results came back “normal” across the board, except for a slight spike in testosterone. Heightened testosterone can be a sign of PCOS. This is how we’ve landed on this “probably” diagnosis.

In response to this “probably,” and having a year and some change between actively trying to treat PBCS and feeling better, I began incorporating some new things unique to PCOS treatment:

PCOS things that DEFINITELY worked:

  • 10-Day Progesterone prescription: THIS is how I’ve gotten my period back. And while it’s not a “natural” period, it is my body naturally cycling in response to an appropriate, bioidentical hormone increase. I can ovulate while on this prescription (though it’s unclear if I am), and my periods are a normal length, consistency, and amount. I start taking each 10-day cycle on day 21 of my cycle so by day 31 I start bleeding. Periods occur in response to heightened progesterone after the collapse of a follicle. This medication mirrors that process.
  • Period cup: This and period underwear I began using moreso in effort to go as low-waste as possible across my lifestyle, but I HAVE to include them both because they’ve absolutely revolutionized my cycle for so many other reasons. When it comes to the period cup, it’s namely that having it in reduces my cramps, significantly. What’s more (and to get real with you) as a person with profound gastrointestinal issues, the period cup helps reduce bowel movement discomfort. Have you ever had the experience of wiping and your tampon string gets yanked? It’s truly awful. No such issue with a period cup. Period cups ARE however notoriously difficult to insert and remove. Here are my tips for discerning cup life:
    • If you’ve never liked tampons, period cups are probably not for you.
    • I do the “tulip” or “pinch down fold” pictured HERE. I have a tilted cervix and find this is the only way I can get it up in there. That link will also provide details for other methods of insertion and removal.
    • The period cup popping open inside you is an odd experience. Not painful, but sudden. You’ll know if it’s open.
    • I highly recommend buying the Dot Cup. It comes with a pouch, and they often run sales. In fact, during COVID they gave away hundreds for free. That’s how I got mine.
    • There’s not good way to remove a period cup in a public restroom with more than one stall. Your hands do get bloody.
    • Because period cups are made from antibacterial plastic, your chances of experiencing toxic shock syndrome are significantly reduced. Meaning, you can wear them for a significantly longer amount of time than a tampon before emptying it.
    • The first time I used it I wept because I thought I got it stuck inside me and Guy had to talk me down through the bathroom door. We laugh about it now. Don’t read the horror stories on the internet.
  • Period underwear: If you’ll recall from my Bleeding To Death installment, I am used to having to change a pad every hour. I was very resistant to period underwear for that very reason: You can’t change out a pad without changing your whole underwear, and then where do you put the used pair? They’re also typically very expensive. But I don’t trust just a tampon or cup without backup, I really wanted to reduce my waste, and I’d heard such amazing stories about period underwear decreasing period anxiety, particularly during sleep. I finally bit the bullet during Thinx’s major annual sale and it changed. my. life. It’s everything I hoped it would be. Comfortable. Doesn’t feel like you’re wearing a diaper. It really IS moisture wicking (so you don’t FEEL like you’re sitting in blood.) I sleep so much better on my period. But I DO have some pro tips:
    • BUY THE TARGET BRAND: Thinx recently partnered with Target to do a discounted line of period underwear. But here’s the deal: It’s the exact. same. product. In fact, the “changes” actually make the product BETTER. Thinx’s original line of period products are not cotton and they’re twice as expensive. Everyone and their mom knows that you should be in cotton underwear, especially when you’re on your period, and especially especially if you’re prone to UTIs. Cotton is moisture-wicking, antimicrobial, and breathable. Thinx’s Target line? All cotton. And half the price. I see absolutely zero reason why you should be buying the original line.
    • Buy the HIGHEST absorbency: They all feel the same, no matter how absorbing they are. There is no difference in thin-ness or comfort, and there’s no difference in price. So do yourself a favor and just buy the ultra absorbent pair because…
    • You can’t tell how much you’ve bled: The entire interior of the underwear is black. Which make sense, but also makes it extremely difficult to tell if you’re leaking. The only problems with leaks I’ve ever had have been in “Level 2” absorbency rather than ultra OR leaking around the edges of the “pad” after lying down. Still far fewer leaks than conventional pads.
    • Hand-rinse them in warm water before putting them in the laundry: Maybe I’m just paranoid, but better to be safe than sorry. This prevents blood from getting in the rest of your laundry, and extra-prevents the growth of bacteria.
  • Eating more protein: This is hard with a broken gallbladder. I can’t eat pork, I can hardly eat beef, and I avoid dairy as much as possible. But I’ve found that when protein is an intentional part of each of my meals, I feel significantly better. I have less fatigue and more energy throughout the day. I naturally eat less because I’m fuller longer. My proteins of choice are eggs, string cheese, peanut butter, Greek yogurt with added protein, chicken, beans, and tofu.
  • Fertility tracking: Even before I got OFF birth control, I began tracking my cyclical symptoms using FEMM fertility tracker. It’s the most intuitive and comprehensive app I’ve found, and it’s completely free. You have access to trained FEMM educators at any time as well, if you have questions. It has options for Creighton, Marquette, and other methods to input respective data. FEMM is also committed to providing comprehensive reproductive health education to young girls. I’ve learned so much about my body through this app, and throughout my PBCS and PCOS diagnoses, it’s been helpful to note what is and is not happening.
  • Strength training: In the last two months, I’ve begun boxing again. I do it once a week and I pace myself, but nothing makes me feel as good and strong and beautiful and healthy in my body as boxing. I am THRILLED to be back. What’s more, I’ve noticed a steady decline in fat on my body and increased muscle. It’s not about weight (I weigh the same, actually.) It’s about the strength of my body and recognizing it as “me” when I look in the mirror.
  • Massage: I am a very, very lucky person. My fiancé is not averse to giving me foot massages. I’ve found that physical touch has been a grounding, key aspect of my healing (to which the pandemic has posed a distinct challenge.) Being held in a variety of ways has brought me back into my body when it has not otherwise felt like mine. Whether caring touch comes from a loved one or a trained professional, regular massage has been a gift from God.

PCOS things that MAYBE worked? (Maybe it’s still the placebo effect?)

  • Ovasitol: This is the #1 recommended supplement for PCOS. Inositols have shown in a variety of studies to work similarly to Metformin with fewer side effects, helping improve egg quality and combat insulin resistance. I used it once daily for a year. I certainly noticed less of a sensitivity to sugar, but my period never came back naturally, so it’s uncertain how much credit I can give it.
  • Seeing a chiropractor: Well into working from home from my desk, I began to experience debilitating pain in my mid-back and hips. I went to a chiropractor–paying out of pocket, because I still didn’t have access to a primary care doctor–and found that while it helped treat my immediate joint and muscle pain and answered to some long-running challenges in my shoulders and hips, it also exacerbated shoulder tension and mental stress if I wasn’t going regularly (which I could not afford to do.) I am now going once a month and that feels helpful, but I’m uncertain if I can call it a net-win outside of acute treatment.
  • CBD: Lots of people who know I have anxiety have shared their miraculous stories of taking CBD and recommended it to me. It seems to be a wonder supplement: Decreased anxiety, decreased inflammation, decreased pain, increased focus, better sleep. I’ve been using Equilibria for about 4 months and despite loving their brand, their customer service, and their commitment to quality, I’ve discovered that CBD only minorly works for me: It reduces anxiety, but it increases my focus so much it actually impedes my sleep, and I haven’t noticed any improvement in my pain.

PCOS things that did NOT work:

  • Going gluten-free: Lots of PCOS gurus online suggest cutting out gluten for PCOS. Here’s the truth: Only people with sensitivity to gluten will see any sort of result from cutting it out. I do not have any sort of gluten sensitivity. Cutting it out, even for just a week, made me irritable and stressed. Like cutting out coffee, maybe it will work for you? It did not work for me.
  • Going back on birth control: It’s the #1 thing doctors tell people with PCOS to do, and its the #1 thing I will NOT do. Birth control got me into this mess, and it doesn’t actually do anything to treat what’s causing it. It just stops a person from ovulating, decreasing the likelihood that cysts will grow from post-ovulation follicles. Using birth control can do a lot of things (manage pain is one of them!) But it cannot balance your hormones.

The only thing left to do to turn this “probably” diagnosis into a “definitely” would be to examine my ovaries for cysts via pelvic ultrasound. If you’ll recall, I had one of those done before after I nearly bled to death, but it came back “inconclusive.” I haven’t had one since and, unfortunately, still haven’t had one. Ultrasounds are not a procedure covered by student health services. Until I have my own health insurance, off of my parents’ plan and onto one accepted in Illinois wherein I can also get a new primary care physician, I can’t access that exam unless I go to the ER.

So it’s here that I want to talk briefly about healthcare access and inequality.

I am a white, upper middle class white lady living in a neighborhood that houses one of the best medical facilities in the state of Illinois. But because of the drama and inaccessibility of the US healthcare system, I can’t access it for routine or acute care. My only option is Emergency Services and Urgent Care. I have incredible health care coverage through my parents’ military health insurance that I am fortunate, through the Affordable Care Act, to still qualify for until I turn 26 this September. But because this healthcare plan is an HMO, I cannot use this incredible health coverage unless I see and am then referred out by my family’s primary care physician….in California. I lose this healthcare in September on my birthday. My only hope is to receive healthcare through my employer (or Guy’s once we’re married…. a whole year later.) Guy’s job does not have corporate health coverage. He had to go through the marketplace, and then have a portion of it paid for indirectly by his boss. While still an immensely privileged opportunity, to still HAVE the marketplace option, the coverage options on the marketplace are…not great. All because the United States makes healthcare a reward for labor, rather than a right.

Now imagine all of that drama, for a person whose parents don’t have good coverage or coverage at all. For a person working a job that doesn’t offer any sort of healthcare. For a person who is unemployed.

Now imagine that this person is chronically ill or disabled, with dire, routine medical needs. With prescriptions they need to survive, at absolutely unjustifiable prices.

Now imagine that person is a person of color, or a member of the LGBTQ+ community (or both.) The very few opportunities for care FINALLY available to them very well might be tinged with disrespect. The care they receive might not be care at all. It might be imbued with racism and personal prejudice. It might be actively violent towards them. It might put them MORE at risk.

Imagine that person has kids.

And then remember: We are penalized by our government for NOT having medical care come tax season!

This. System. Is. Nuts.

It makes health a reward for working, and the more work you do the more of your body you are allowed to possess. What’s more, it disproportionately rewards those positions occupied by persons who came to the job with the help of inordinate privilege.

Health should not be a reward for work. You should not have to work to deserve health. To think this is the case is deeply ableist. It views people as only worthy to the extent of what they can do and produce.

This is, additionally, why it is so important to divest from religious models that encourage “praying pain away” and the like.

I write more about it for The Young Catholic Woman HERE. But I’ll briefly say more now: I prayed for healing, for years. I prayed that God would take my excruciating H. Pylori pain away. I prayed God would stop my bleeding. I prayed God would stop me from gaining more birth control weight. I prayed God would bring my period back. I prayed for my anxiety to go away. I prayed to be able to eat beef. I prayed for an end to hormonal acne. I’ve prayed for it all.

God did not enact any physical healing miracles in my life.

For a good long while, I was pissed. I thought God was entirely absent. I thought I “deserved” this pain for making choices I thought were in my best interest and maybe weren’t? I thought God wasn’t real. If He were, He would hear my prayers and answer me.

So many Christians feel this way. And it is wholly, completely untrue.

In fact, it’s ableist of us to think it IS true.

What’s more: God does not will suffering. God is not punishing you by making you sick. Disability and chronic illness and mental illness or not symptoms of sin. (He tells us so, right in the Gospel of John, Chapter 9.) They are natural functions of the body that everyone experiences, at some point in their life.

Again: We cannot and should not have to earn our health, just as we cannot earn our holiness. We think we can, especially as we’re inundated with stories about sainthood. We think these people earned their sainthood through their lives of service and prayer. This is not the proper way to conceive of sainthood. The saints were people who received grace-filled gifts, and then did something with them. They didn’t do something and then earn grace-filled gifts.

Catholics are especially guilty of this mindset, with our emphasis on practices, rote prayers, and sacramental milestones. We think that if we check all the boxes, God MUST respond in x, y, z ways. (I talk about this in the context of dating and marriage in THIS article.)

We can also approach the earning of health from a totally secular path that leads us to the same place. We are equally inundated with influencer advertisement for practices, supplements, workout regimens, etc. To a certain extent, this post is guilty of doing just that! We can believe that if we do all of these things, we DESERVE good health as the result and we WILL achieve it.

This is also not true. I tried every single one of those things listed under PBCS resources. Not ONE of them led me to getting my period back “naturally.” Sure, they made me feel better. They attended to other concerns I had. Not one led me to the ultimate outcome I was praying for.

Even if we do ALL the things, we might NEVER be healed. Neither by our own hand or by Gods. Healing is not earned. Physical health is not a right. It is an immense, immense privilege.

This doesn’t mean stop praying. It also doesn’t mean stop seeking medical attention. To quote my man Hans Urs von Balthasar: It means we “reasonably hope” for healing.

We can pray for our healing to end, offering it up as a form of prayer in and of itself, and reasonably hope that healing comes, with the full knowledge that if it doesn’t, it is not a reflection of our goodness. We can reasonably hope the supplements work, with the full knowledge that if they don’t, we are not to blame. We can hope from a place of true humility in one hand. And we can rage about how much this f*cking HURTS in the other. Both are very good. God holds space for both.

As of today, June 25th, 2021, I have had one major update: During this last cycle, I spotted on my 15th day. Ovulation typically takes place half-way through one’s cycle, around day 15. While this is not a surefire way of indicated that I’ve ovulated, given that this used to occur long before my birth control experience, I’m taking it as a good sign. However, this doesn’t rule out the likelihood that I have ovarian cysts. If I am in fact ovulating again, bleeding while I do very well might indicate some sort of obstruction or growth that is impacting the process. There is a real part of me that actively fears ovarian cancer. What I need is a pelvic ultrasound.

I’m hoping and praying that August 1st comes quickly, so I can shift onto workplace medical care and see a specialist as soon as possible. Until then, I’m going to keep doing what works, keep filtering out what doesn’t, and keep sharing in some form or another this series of unfortunate menstrual events. It’s only by sharing our experiences that they can become normalized. I’m grateful you’ve taken the time to listen to mine.

With love — Madison

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health PCOS

Trust Your Gut

My Mom raised me to trust my gut. If something was wrong, I felt it deep in what she called my “conscience.” People I know now tell me it’s “Catholic guilt,” but it’s not. I didn’t grow up in a household where God was frightening and mad at me. I didn’t grow up going to Confession. I grew up with a Mom who regularly reminded me that my body would tell me–through an upset stomach, anxious feelings, a knot in my chest, poor sleep or bad dreams–that something was wrong.

My body on birth control was telling me something was wrong. So I got off the birth control pill. Problem solved, right?

Wrong. Very, very wrong.

I assumed that, because I was forcibly cycling my body through hormones every month, that it would continue cycling using the hormones it naturally produced. Maybe that would be the case if the hormones you were supplementing with were bioidentical (in other words, structurally similar or identical to hormones the body naturally creates.) Hormonal birth control is not. The “cycle” I experienced on the Pill was not a cycle at all. So, when I got off of it, my body. freaked. out.

I went a month anxiously anticipating a period. In fact, I expected my severe blood loss to come back like it had when I was prompted to get on the Pill in the first place. I also (secretly) hoped the weight I’d gained would fall off as quickly and effortlessly as I’d gained it. It feels silly, and deeply sad, to say it aloud.

I didn’t have a period. What I did have was stomach pain. I first noticed it after eating. At the same 30 minute interval, after eating dinner every night, a specific spot in my upper abdomen felt a sudden, sharp stab. It was accompanied by nausea, cramping, severe bloating and dizziness. Suddenly, I had the need to drink water and lie down after every dinner.

Given that I was living in intentional religious community, this was my first experience of the difficulty of explaining chronic illness symptoms to loved ones and coworkers. I had been struggling in community for months, retreating to my room after work as the most introverted in the house, butting heads with a cranky Brother, and grieving the death of a community loved one. Now, I couldn’t bring myself to sit through night prayer without doubling over in discomfort. I suspected that my community members questioned whether I was simply moody and resisting community involvement.

After four or five days of experiencing this nightly discomfort, I began experiencing it in the middle of the day. At the time, I was teaching middle school religion in the afternoons post-lunch. I would eat, go to teach, and start feeling sick by half-way through my first class. I immediately confided in my mentor teacher, who suspected I was experiencing a stress-induced ulcer. I was told the same things the internet told me: To get more rest and try to reduce my stress.

As a full-time, volunteer middle school teacher living in a community in which I felt unsafe, grieving and lonely… how? Besides taking my time to attend to my post-meal pain, there was not much else I could do, and I didn’t have much spare time. I needed to be present in community, and I also needed to be present at our short-staffed school. Despite these anxieties, and not having access to a regular physician, I finally bucked up the courage to pursue medical care, and went to a local Tulsa urgent care clinic.

I was examined and given an abdominal x-ray. I informed the doctor about my recent shift off of birth control, and asked if perhaps my digestive issues had anything to do with that? The doctor assured me, no. Looking at my x-ray results, I was extremely constipated. She encouraged me to drink lots of water, keep taking Miralax, if that didn’t work take Metamucil, and if THAT didn’t work, Citric Acid. After that, if I still experienced the stabbing pain, I was probably experiencing intestinal irritation from being backed up and was told to take Zantac and Pepto-Bismol.

I won’t burden you with the details of my bowel movement failures. Let’s just say: I ended up having to take all 3 laxatives and they worked as expected, yet none of my symptoms actually changed. In fact, my pain worsened into unpredictable bouts of the most excruciating pain I’ve ever experienced in my life. Eating or drinking anything–or not eating or drinking anything–could leave me keeled over on the toilet, screaming in pain. Like being stabbed from the inside out, unable to move, unable to eat, I went three days self-medicating with antacids, milk, mashed potatoes, crackers, Pedialyte, and stool softeners, praying that whatever was inside me would just get out.

The doctor at the Urgent Care clinic had told me if things got worse that I may have an intestinal blockage. This scared me. I hadn’t eaten anything nonedible. If I had a blockage, it was either some sort of bump or twist from overeating, or it was some sort of growth. Colon cancer does not run in my family, but it is becoming increasingly common among young people. After three days of excruciating pain, trying to stay present to my students and my community, I went to the Emergency Room. Twice.

The first visit, they did triage and then sent me to the dangerously backed-up waiting room. There was a young girl in a hospital bed that had been rolled into the waiting room, sweating profusely, keeled over in pain, wailing about having been waiting for 13 hours. I looked at Brother Richard, horrified. We couldn’t wait that long. So we left.

I didn’t sleep a wink that night, slumped over the toilet bawling. We went back to the ER the next morning. This time, it was far less busy, and I was able to be seen right away. They performed another X-ray and CAT scan. They examined my colon, liver, appendix, and spleen. They also tested my blood for infection. They noticed no inflammation or blockages in any of my organs, and I came back free of infection. But I was heartbroken: No answers. And they said there was nothing else they could do for me except refer me to a GI.

I took the referral and went two days later. The GI took a stool sample, which came back with trace evidence of a stomach bacterial infection. He schedule me for an endoscopy, a procedure similar to a colonoscopy where your digestive tract is examined (just from the top-down instead of bottom-up… literally.) I would be given anesthesia and the procedure would take a couple hours as they both inserted a scope down into my intestines and took a small excision sample. It was and is still the only surgical procedure I’ve had done outside of wisdom teeth. I was scared. Brother Richard went with me, and let me sing a loopy song about how excited I was to be able to eat chicken nuggets after my procedure. I hadn’t eaten solid food in two weeks.

Again, my heart breaks to say it. The doctor said the scope came back inconclusive. I showed evidence of having recently healed from a number of ulcers, but I had no active ulcers. The excision, again, showed trace evidence of a stomach bacterial infection. But, the doctor said there wasn’t enough evidence to be concerned. He could prescribe me antibiotics, but he didn’t think I needed them. He said I could control my pain through diet, exercise, and stress-management.

I was distraught. Wasn’t that what I was doing? I wasn’t eating ANYTHING! I couldn’t go to work, I couldn’t eat, I couldn’t sleep. All I could think of was that whatever I was doing to manage it, I wasn’t doing enough. Not to mention I had just shelled out money for urgent care, not one but two ER visits, a GI appointment, and now an inconclusive procedure. I guess I just had to keep suffering until I was better. No chicken nuggets.

My pain did not improve. I still could not eat. Guy came to be with me for a few days, as I prepared to go back to teaching for the final two weeks of the school year. I couldn’t imagine not seeing my students again and closing out the year. He shopped with me for baby food, in the hopes that I could safely stomach the vile puree. At the time, he and I were 8 months into long distance between Oklahoma and Alberta, Canada. He was the only person who came to visit me during my time of illness.

Just before my last week of my year of service, I traveled to Chicago for our volunteer program’s debriefing weekend. I still could hardly eat, and when I did eat, I was still left doubled over in pain and horribly nauseous. After every meal, I had to take time in my room instead of immediately transitioning to the next of the weekend’s activities. I couldn’t connect with any of my fellow volunteers from around the country (and given that I’d spent a year being pretty relentlessly bullied and ostracized by a good portion of them for college-old rumors, none of them particularly cared what I was experiencing anyway. Again, the volunteer environment I was in left me ripe for judgment and suspicion. She’s probably just looking for attention.)

Finally, on my last day of debriefing, pieces clicked into place for my boss. She paused, pulled me aside and said, “Wait. Do you have H. Pylori?”

“Yeah, exactly.”

“Why aren’t you on antibiotics?!”

“The doctor said I didn’t need them, and could manage with diet and rest.”

She was seething as she told me her story of having an H. Pylori infection in high school. It was excruciating. All she could stomach was Gatorade. The only thing that helped was antibiotics.

In fact, with a stomach infection like mine, all of the things I had been told to do by the urgent care doctor had actually made all of my symptoms worse. H. Pylori feeds off of fibrous material, like mashed potatoes, baby food, and Metamucil. Antacids may have reduced acid caused by the ulcerous bacteria, but it was also coated my stomach lining and allowing the bacteria to dig even deeper.

I was floored. “Why would the doctor tell me I don’t need antibiotics then?”

“Because he sounds like an asshole male doctor who devalues women’s pain and has never had it himself.”

It was my first time experiencing such explicit bias against women and women’s pain. This bias is so rampant, and is 3x higher against women of color.

Because I was going home to California in a week, I waited and scheduled an appointment with my primary care physician in which I directly requested antibiotics after presenting a folder full of the findings from the endoscopy.

Within 3 days of taking them, I felt better. I no longer had that stabbing pain the middle of my abdomen, and I could eat food without immediately triggering an onslaught of excruciating pain.

If there’s anything to be learnt here it’s this: H. Pylori is the cause of ulcers 90% of the time. Stress can make it worse, but the root cause is typically bacterial infection. You cannot fight bacteria without antibiotics. You can get lucky and maybe it goes away, but to actively fight an invasive bacteria, you need an antibacterial. Your pain is valid. You deserve the relief trusted medication provides.

But even after antibiotics, I still felt extremely nauseous. Eating still tired me out like no other activity. I still had to go lie down after every meal. I still had extreme bloating.

Now I’m going to pause here and yell at diet culture for a minute: 9 times out of 10, when we see or hear complaints about bloating, it’s that it makes your stomach bigger and your pants not fit. Nobody talks about the fact that bloating can be extremely, extremely painful. Again, when we talk about the problems facing women’s digestive health, so much of it surrounds weight gain that the solutions often focus solely on weight loss, completely sanitizing the reality of pain. Hear me now, bloated women: You deserve to not be bloated, not because it makes you larger, but because it. hurts. very. much. And you deserve to not be in pain.

When I followed-up with my primary care physician after finishing my round of antibiotics, she asked if gallbladder problems run in my family.

Yep, they do. Not a single Chastain over the age of 21 has a working gallbladder, actually.

My doctor sent me to get a HIDA scan, in which you lie on a table and are injected with a dye that lights up your gallbladder. You then consume a substance that tells your body to mimic its response to food in need of digestion. As you lie on the table for 45 minutes, the large machine above you monitors the release of the dye from your gallbladder. For those who have never given any thought to their gallbladder, this is what the gallbladder does: While your liver always and everywhere stores and releases bile to help break down your food, your gallbladder (which is connected to your liver) stores extra bile to be released when you eat food that needs extra help breaking down. Think greasy food, processed food, fatty food, leafy greens, red meat, and highly acidic foods. Your body also relies on bile from your gallbladder if you eat while drinking, as alcohol naturally impairs the liver.

The physical results from the scan were immediate: I broke out in sweats, my stomach bloated immediately, I felt nauseous and dizzy. The data was just as telling: Over the course of 45 minutes, my gallbladder had only released 4% of its contents. My gallbladder wasn’t working.

Now, gallbladder failure can have a number of causes: Gallstones, inflammation (cholecystitis), or… it can simply stop working. This is called “lazy gallbladder,” and it’s what runs in my family. No inflammation, no stones, just… a broken organ.

The nurse at the hospital who conducted my scan was extremely comforting and understanding. She let me cry tears of relief at finally having an answer and walked me through my options. The most important thing is managing my diet by avoiding the foods I listed above. If I don’t, and I continuously tell my body I need extra bile it can’t provide, my liver will continue to send extra bile to my gallbladder to store, not understanding that my gallbladder isn’t releasing any. This can cause a back-up, which can then lead to gallstones or inflammation. This is what leads to people getting their gallbladders removed alltogether.

This choice is different for everyone. The HIDA nurse herself told me she has a broken gallbladder but hadn’t had hers removed. My dad and many of his family members have had theirs removed, but a couple family members still have theirs. A conversation I had with my dad was really helpful: “Once you get an organ out, you can’t get it put back in,” he said, “and truthfully, getting it out doesn’t actually save you from digestive problems, it just gives you new ones.” Meaning, if you take out the organ that regulates bile release, when you eat those problem foods I named, instead of being backed up with not enough bile, your liver overproduces bile, which leads to you digesting too quickly. Which leads to problems like chronic diarrhea and lack of nutrient absorption. Gallbladder problems are like being between a rock and a hard place: There’s no perfect solution.

To this day, I am still managing my gallbladder failure. Up until about a year ago, I still experienced regular symptoms. If I ate too much food, I often ended up vomiting because my body couldn’t digest it all. There was a time I couldn’t eat if I was also drinking alcohol for the same reason (definitely doesn’t help that “pub food” is pretty much exclusively foods on that list of “no-go’s.”) The first time Guy ever saw me puke was after my former roommate’s graduation party. I had eaten pizza and drank a lot of wine (it was hosted at an Italian restaurant! What are you gonna do??) I was FaceTiming Guy afterwards– we were still long-distance–and with absolutely zero warning, I projectile vomited all over myself, my bed, and the phone I was using to call him. It was… gross. And again, I had to explain my mad dash to the bathroom not only to my roommate, but to her entire family that was there for her graduation. I am sure there was some small part of them that wondered, like my fellow volunteers and my intentional community the year before, what on Earth was wrong with me and if it wasn’t in some part an attention grab. I was extremely embarrassed.

Learning from these moments, here are my “gallbladder management” habits:

  • I don’t eat tomatoes, pork, or cauliflower. Basically ever.
  • I eat beef, broccoli, and brussel sprouts very rarely.
  • If I experience gallbladder pain (which to me, feels like a pinching or stabbing feeling up under my right ribcage) I take a hot shower or bath, apply a hot compress, take a multivitamin, and drink a ton of water. In my early days I occasionally utilized castor oil packs, to some success.
  • If I experience a gallbladder attack (which is when I experience massive bloating, cramping, nausea, and vomiting due to overeating or constipation), all I can do is drink a ton of water, sit on the toilet with a cold compress on my forehead and neck, and wait for it to pass. Gallbladder attacks are really scary, and the immense pain often sends me back to my weeks in Tulsa alone and afraid of what was happening in my body. Now, with the help of counseling, I’m learning to try and extend my body pride and compassion. It knows something is wrong. It knows it cannot process all the food inside of it. It wants it all out. And it is doing a good job, its exact job, to try and fix the problem.

I suspect that, with the work I’ve done on managing my diet, my gallbladder is functioning more than it used to. I can eat more processed foods and healthy fat without experiencing pain, and of all of my symptoms I’ve noticed the most marked difference in my bloating. I’m really proud of myself.

That being said, figuring out what to do and not to do took years of trial and error. After over a month in Tulsa of not being able to eat at all, I had developed a disordered relationship to food: I was scared of eating. Not because I was scared of gaining weight, but because I was scared of messing up my stomach and causing myself pain. I didn’t trust myself, neither my food choices nor my body. I was anxious any time I went out to eat with friends. I got really into cooking, if only because I was forced to try a new combination of foods every night to see how my body responded. I didn’t trust doctors to tell me the truth, either. Not after my experience in Tulsa.

I am still healing. I am still learning to trust my body’s ability to digest, and my mind in making smart choices. Most importantly, I still really struggle with beating myself up during a flare-up. I often blame myself, that if I hadn’t eaten X, drank Y, or stressed out about Z, I wouldn’t feel this way. I often also catastrophize: Meaning, I often jump to a worst case scenario. “This is going to make me vomit,” or “This is going to send me back to the hospital.” Thanks to counseling, I can now identify these as trauma responses. I am working on them.

But Madison, this is a series on PCOS. What on Earth does ANY of this have to do with your period or hormones?

Remember when I asked the Urgent Care doctor if any of this had to do with getting off the birth control pill and she said no?

Ha. Haha.

I should’ve trusted my gut.

I could go on and on explaining the science, but I would rather direct you to the person who pioneered it: Dr. Jolene Brighten. Dr. Brighten is a leader in women’s menstrual irregularities and has coined the term “Post-Birth Control Syndrome.” Again, thanks to my counselor (who I hope you’re starting to see is a key player along my health journey), I was referred to Dr. Brighten after sharing the story I’ve just shared with you.

Here’s the gist of what I have learned: When you take medication, much of it is filtered through your liver. Especially when that medication is hormonal in nature, your liver works overtime processing the foreign hormones. We know that there are many frequently-prescribed drugs currently on the market that pose risks to liver function for this very reason. Birth control, we are actively learning, is one of them. And what threatens the liver, threatens the gallbladder. For those genetically pre-disposed, birth control can lead to early liver or gallbladder stress and even failure.

What’s more, hormonal birth control has been linked to decreased immune function and irritation of the digestive tract. Meaning? A person on hormonal birth control, like many other medications, is at increased risk of infection.

With your body on such high alert, when its primary concern of processing these hormones and forcing a non-cycle cycle is taken away and you get off birth control, it typically takes a very long time for your period to come back. Not only does your body have to relearn how to naturally produce and cycle all your natural hormones, but it also has to address the outlying issues of infection, inflammation, organ failure, stomach dysbiosis, and more. Sound familiar?

Now, one of the things I appreciate about Dr. Brighten is that she is not outright anti-Pill. She repeatedly affirms that not only is it sometimes truly the best medical option for a woman, but that beyond anything else it is extremely difficult for a woman to avoid birth control in the first place, since it is prescribed as the band-aid for so many women’s health issues. But, Dr. Brighten frequently says, it is important to get to root causes of hormonal imbalance before applying the Pill as a band-aid solution AND there are many things it is important for women to do while on the Pill to support the body.

This should be at the heart of Catholic theological and ethical discussions of birth control: Has the woman had ample time and resources made available for her to explore the root cause of her symptoms? Is her primary concern that of her health and not of contraception? Has she been educated in the ways she can support her health and fertility while on the Pill? Health and safety should always be held in priority above “a slippery slope to enabling promiscuity.” If women fear taking the Pill, it should be because they are fully informed about the real and severe medical risks, not because their Church has made them feel guilty for pursuing something viewed as heightening sexual temptation. In fact, the latter actually enables distrust of one’s body: If you are constantly being told by religious or moral figures that you can’t trust your body not to lead you astray, then you are not going to trust your gut when it’s telling you something is wrong. Your body is good, it knows what to do. Listen to it.

For those who seem suspicious, I get it. Dr. Brighten has a line of supplements, a book, her own series of courses you can pay to take, and she hosts a yearly conference on hormonal health. I have paid for one of these courses, read her book, taken the supplements, and frequently refer back to her hundreds of free articles. Let me assure you, I am not on any sort of payroll. Nor do I necessarily agree with the popular, online influencer strategy of putting life-changing information and helpful supplementation behind steep paywalls. This is why I urge you, if any of my experiences sound like yours, to read her articles (with a grain of salt.) Read her book (with a grain of salt. AND request it from your local library: In this house, we support local communities and the environment and always go to the library first!) I also recommend the Period Repair Manual by Lara Briden, which alongside Dr. Brighten’s book, is the other leading text exploring contemporary science about menstrual health. Pursue the free knowledge first before diving deeper.

Most importantly, talk to your doctor (but take their advice with a grain of salt, too.) Medical practices you find in the doctor’s office, unless your doctor is affiliated with a research institution or is reading up on contemporary research, averages 17 years behind results from current studies. Just because your doctor doesn’t know about a study doesn’t make the study false. A good doctor will explore it with you. In the same breath, just because a study says something is true doesn’t mean it is. Scientific discoveries must be repeatable to be valid AND if they are to be just and equitable, they need to be repeatable across a wider demographic than the usual suspects. In short: If Black women weren’t consulted, there’s more work to be done.

I also urge you: Listen to your body. Trust your gut. No matter what any professional says, not everything will work for you. I couldn’t follow Dr. Brighten’s course to a T, because her food plans did not account for gallbladder failure, and many of the ingredients were on that “difficult to digest” list. When my primary care physician finally prescribed me antibiotics, she also suggested I get back on the birth control Pill. In Tulsa, I needed fewer antacids. In college, I needed to explore why I was bleeding before I jumped to birth control to make the bleeding stop. My body was showing me, all along, that something was not right. But we shouldn’t beat ourselves up for not listening the first, second, third, or thirtieth time. If anything, from this story it should be clear that whether you’re the patient or the medical professional, it’s all basically (and extremely unfairly and unfortunately) a guessing game when it comes to women’s health until this all becomes prioritized, common knowledge.

So that’s the end of my health past, but I am still surmounting a health present. For the next and final installment of this series, I’m going to briefly explain how I got from Post-Birth Control Syndrome (PBCS) to Poly-Cystic Ovarian Syndrome (PCOS) and identifying as chronically ill, and then present you with my totalizing list of things I’ve tried, broken down into categories of things that…

  1. Definitely helped
  2. Maybe helped? Maybe it was a placebo effect?
  3. Didn’t help at all

My email and DM’s on Instagram are always open. As you may be able to infer from my digestive ailments, nothing (polite) grosses me out anymore. Maybe don’t send me unsolicited toilet bowl pics, but if you have a question, experience, or concern, I love to hear them and walk with you through whatever you’re experiencing.

Big love–Madison

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health PCOS

Second Puberty: Thoughts on Birth Control

Last time we talked, we were chatting about periods and bleeding to death. At the end of that story, the ER’s on-call OBGYN said I needed to get on the birth control pill to stop my excessive bleeding. When you’ve almost died from blood loss, anything that makes you stop bleeding sounds like a good idea.

To be honest, the thought of taking birth control made me feel… mature. I was a junior in college who was not sexually active and wasn’t interested in being sexually active. Waiting to have sex until I was with my spouse was something I personally valued. But I had so many friends who were on birth control, whether it was for acne or cramps or otherwise. Like my cheerleading teammates whose neon green tampons I yearned to borrow in high school, I felt like I was joining the ranks of young adult womanhood by having a tiny pill to take every day.

I am sure there is something to be said here for how modern-day feminism has sold women’s physical (particularly sexual) independence. Pill packs come in all sorts of candy colors. IUD ads populate romcom commercial breaks. It is glamorous to have a habit that suggests sexual maturity. Much work has been done breaking down the harm this push for birth control does to women. Of biggest concern to me is the way this glamour masks a lack of informed consent and comprehensive sexual education.

The Church situates itself staunchly against this idea of a woman’s maturity or freedom meaning dependence upon sterilization, abortion, or contraception. However, only very recently has the reasoning for this set of beliefs really shifted towards “wanting women to understand their bodies, chart their cycles, and get to root causes in defense of human dignity for every life” and away from “these medications and practices encourage sexual immorality and irresponsibility.” This is in no small part due to the increase of lay women driving Catholic conversations online. As a result, there seems to be a greater space for topics of sexual violence and medical complications among these discussions. But between the old-school concerns about a slippery sexual slope and contemporary “wellness culture” that says you should be able to know and treat your body’s concerns 100% on your own by peeing on a test strip, charting cervical mucus daily, taking your temperature as soon as the alarm goes off, and using a unique blend of herbs and spices designed to balance your hormones, the Catholic world still doesn’t talk much about situations like mine.

Taking birth control for a valid health reason does not violate Catholic Church teaching.

Let me say that again: It doesn’t violate Church teaching to take hormonal birth control for a health reason independent from contraceptive use. Even if you’re married and having sex! If you are using hormonal birth control primarily for a valid health reason separate from contraception, then the intended consequence takes primacy over the secondary consequence of preventing pregnancy. This is what’s called the ethical principle of Double Effect. But, you have to 100% NOT intend the secondary consequence. So if there’s even a small part of you utilizing hormonal birth control for a contraceptive reason, then yes. That would violate Catholic Church teaching.

What we see is a confusion about what it means when the Church requires a marriage be “open to children.” When the Church says “openness to children,” it means that you agree to not act in such a way that intentionally prevents children and, if you were to become pregnant, you would bring that child to term. It is confusing: hormonal birth control prevents children 91% of the time. But if you do not intend to prevent children, and are taking birth control because you are literally bleeding to death, you’re in the clear.

There may be a bit of debate around weighing the proportional significance of certain outcomes. For example, if you are a married person taking birth control pills to prevent acne primarily, all the while it is acting as contraception secondarily, the Church might say that the secondary outcome is proportionally greater than the first. Proportional justification is difficult, and I’ve taken us into the weeds a bit with medical ethics. But it is important to me that YOU, reader, know that you don’t have to forgo birth control and put yourself at risk of reproductive injury (or death) to receive the Eucharist. And hey you, if you’re on birth control, Jesus wants to be with you in every part of your life, no matter the reason you’re on it (even if it IS for contraceptive reasons.)

The number of church leaders, men and women alike, who have articulated to me in one form or another that it is impossible for women to not implicitly desire contraception when on birth control is astonishing. Time and again we see the theme that women are intrinsically sexual and seductive, dating all the way back to our girl Eve. This anti-pill rhetoric is reminiscent of the mid-20th century, where ads arguing against birth control displayed a new type of woman that was dangerous, feminist, financially independent, sexually exploratory, and a threat to traditional, maternal family values (a type of rhetoric we now often see used to characterize LGBTQ+ folx…)

But these are not the only groups that suffer from discrimination within conversations of birth control. For decades, it was customary to put women with disabilities on the pill, regardless of symptoms or circumstances. This custom was both eugenic and predatory: It was designed to combat the potential for the passing on of “compromised genes,” all the while making it easier for disabled women to be sexually abused in care facilities. The justification for the procedure was often that intellectually disabled persons had heightened sexual appetites, in some cases even believed to be natural-born sexual predators. Sometimes, it was done simply to make caregivers’ cleaning jobs easier: No menstrual blood. Many disabled women were also forcibly given hysterectomies.

This violence against disabled people is sickening. For these reasons, contraception among the disabled community is a tricky subject. It is important to combat stereotypes about heightened sexual desire. However, disabled persons also suffer from paternalistic infantilization that suggests the disabled are more childlike and lack sexual appetites completely. Even well-meaning parents can minimize their children’s sexuality, often viewing pubescent and adult family members with disabilities as younger than they are. This is also dangerous and untrue. People with disabilities can experience attraction just like anyone else, and to restrict opportunities for dating, marriage, and intimacy would itself be discrimination as well.

Care must be given to acquire full, informed consent, given to the degree that it can be from the individual (secondarily, the individual’s family.) Just as we work to dismantle the virgin/slut dichotomy under which women are held to both “pure” and “sexy” standards, so too must we work to dismantle the same dichotomy as it appears to oppress disabled persons.

Disability complicates this theological discussion of birth control in important ways. The Church would say that prescribing birth control for contraceptive reasons is always wrong, and to encourage sexual intimacy outside of marriage is wrong as well. However, we must understand that the acceptance of the Church’s moral teachings falls to the responsibility each individual has to their own conscience. To force a Church teaching upon a person who does not fully comprehend it, in a way that would infringe that individual’s rights to self-determination, if that person expressly articulates the desire to act in a contrary way, and in a circumstance where that individual depends upon assistance to achieve their goals, is something we should consider a sin. It is perfectly acceptable for us to say, “It would violate my conscience to help you do that, so you might need to find someone else to help you.” But, to outright deny a person the aid they request or to implicitly work to prevent it is prejudicial.

Through conversations I had with youth ministers, pastors, and teachers while I was on the pill, it became clear that hormonal birth control is still largely viewed as a “gateway drug” to sexual behavior. “Once you have the pill, what’s stopping you from having the sex?” Well…. self-control. Lack of desire. Lack of partnership. Personal values. Religious values.

The reality is, birth control pills are medicine. Even if they shouldn’t be medicine.

There is no reason we ought to accept birth control as the height of women’s medicine. With the immense amount of risks and side effects involved, with the uneven distribution of pressure it places on women for sexual responsibility, and with the ignorance of the female body that it fosters among medical communities, I think it’s about time we kick hormonal birth control the curb and discover something else!

But for now–and back then, when I myself got on birth control– the pill is the near-universal response to hormonal disruption and reproductive concerns. I didn’t want to have sex. I just wanted to stop bleeding and cure my iron-deficiency anemia. I wanted to be able to go to a store while on my period. I wanted a pair of underwear to last longer than a month.

For all of these reasons, I never asked my doctor any follow-up questions about hormonal birth control, and he provided me no facts. Other than an aside from the pharmacist that birth control can increase risk of cancer and that I should invest in compression socks when traveling to avoid clotting, I was told nothing.

At first I was put on the “low dose” pill. But after a week of pills, which should have indicated to my body that my period was done, I was still bleeding from that original period that induced my hospital stay. My doctor indicated to me that this meant the pills were not working, so he put me on a higher dose. Looking back now, I can see what my hormones were trying to say: something was really low.

The higher dose worked immediately. I FINALLY stopped bleeding.

But you know what else happened immediately? Weight gain. Within 2 weeks of birth control pill-taking, I grew two cups sizes and none of my pants fit. I had to go shopping for all new bras, underwear, bathing suit, pants, and even some shirts.

I don’t think women quite talk about this enough, the financial strain and frustration of fluctuating weight gain. Shopping for clothes when your body looks and feels unfamiliar is extremely challenging. I felt like a stranger to my body, and I didn’t know how to dress her or make her feel like me. I still don’t. Even after all these years, I’m still dealing with weight gain, stretch marks, hair loss, and more that have left my body feeling like not-my-body. This isn’t about being upset at my body’s largeness, it’s about being upset at my body’s unfamiliarity. At first, I felt so much shame in those feelings. I felt like I was betraying my friends and family whose bodies mine now looked more like. But there is a way to articulate disappointment at weight gain that isn’t inherently judgmental or fatphobic. My body has changed. That is hard.

Besides the weight gain, only one other side effect became immediately apparent: Sensitivity to sugar. My sophomore year of college I pretty much only ate Captain Crunch. From the moment I started on birth control, my stomach was upset when I ate anything sweet. Those frosted cake cookies from Safeway? I couldn’t eat a single one without feeling nauseated. I. Was. Bummed.

In many ways, I noticed less happened than I expected. My acne persisted. My iron-deficiency improved dramatically. I even started having cramps during my periods, something I’d never experienced before. But between my new body and my new surges of hormones, my emotions were all over the place. I cried at the drop of a hat (still do.) My rage felt stronger than before (still is.) I felt like I was going through a second puberty. Women will respond to hormonal birth control differently. Many women I know started taking it specifically to quell acne and cramps, with success. This wasn’t my experience.

Things plateaued for Madison. I went through my junior and senior years of college relatively unperturbed. But I still had to buy new bras and clothes every few months as my weight steadily increased. There was one instance my senior year where, for my trip to India, I took both an oral typhoid vaccine and daily malaria pills. I’m not sure which was contraindicated, but I started bleeding at the airport and bled for 17 days. It wasn’t a high quantity of blood, but it was a long period, despite me being on the pill.

Things got more serious the year after I graduated college. My year of post-grad service was challenging for a host of reasons, so my feelings of depression at first felt circumstantial. But as months went on and I established a regular workout routine of boxing, in part to deal with my negative emotions and in part to combat the weight gain that was still ongoing, I realized that neither were improving. They were, in fact, getting worse.

I began watching fitness videos on YouTube, to supplement my serious lack of income with which to pay for regular boxing classes, which led me down a rabbit hole of videos on hormonal health and fitness. (More to come on which channels/YouTubers helped me the most!) Through these videos, it occurred to me that we never did any work to determine the root cause of my immense bleeding before I got on birth control. When a pelvic ultrasound came back inconclusive, the doctor scrapped it and said “eh, it’s probably not an issue.” When I asked to do hormonal blood work, they said “You’ve lost too much blood and your hormones are already too out of whack for us to glean anything from them.” And in the years since, every time I saw the doctor, I was told that being on birth control was the best thing I could be doing anyway, and it wouldn’t serve anyone to look into my reproductive health any further until I was ready to have children.

I know this is a refrain many women hear. This is how doctors have been trained to respond to women’s health! Hormonal birth control has been sold to doctors as the magic solution to a host of women’s hormonal ailments, and so it is sold to us. Childbirth is sold as the be-all, end-all of a woman’s vocation. It doesn’t occur to doctors that a woman might value her health in and of itself rather than as a tool for her future childbearing. What about women who don’t want children? In case I haven’t said it in a while: God cares about your body, regardless of what it can or will do or produce.

It is good for you to be healthy, and to have greater knowledge about your body, regardless of whether or not childbirth is a part of your story.

In my upcoming post on the educational tools, tips, etc. that I found helped me in my understanding both of the way birth control works and the contributing factors to root cause diseases, I will refer you to the medical professionals I myself leaned on. I am not a doctor.

I will say, through my initial research that post-grad year, I leaned that the hormones I was putting into my body were not bio-identical. Progesterone and progestin are different: The first is what your body makes, the second is a chemical that looks like it. All of this to say, the bleed you experience while on birth control is not a period. It’s a “withdrawal bleed.”

What’s more, I began to see that if hormonal imbalance was at the root of my heavy bleeding, supplementing my body’s natural cycle with artificial hormones was not going to allow my body to “right itself” and start cycling properly. I was, however, hopeful that my body might have learned something after 2 and a half years on the pill, and that my cycle might come back a bit less heavy afterwards.

(Spoiler alert: It did not come back. At all. Still hasn’t. Not really.)

The April of my post-grad year, I transitioned off of the birth control pill. I was tired of feeling like I wanted to crawl into a void every day, like no one would miss me if I were missing or dead. I had never had thoughts like those before. I was also tired of working hard on strength training only to find that I was still gaining an average of 10 pounds every 6 months.

What happened after I transitioned off the pill was the scariest place I’ve been health-wise. That will be the subject of the next installment in this series. Want a sneak peek? It has almost nothing to do with hormones or my period, and everything to do with my gut.

I am proud of the way I made the most of being on hormonal birth control. It got me thinking about the Church’s stance on birth control. It got me researching my cycle for the first time. And I used my experience as a launch point for discussions with religiously conservative friends and family with whom I tried to expand on limited views of hormonal birth control and women’s sexuality.

What’s more? I told my middle school students I was on the pill. Think that’s crazy? TMI? Breach of boundaries? Inappropriate for a Catholic school? I would’ve thought so too, but 1) they asked 2) I don’t lie and 3) it ended up being the best lesson I ever had with my students. I wouldn’t change a single thing. I’ll be writing about that soon too 🙂

In brief? Women are in control of their bodies and sexuality. Providing all women with accessible healthcare is important. Birth control is healthcare, but that doesn’t mean it’s the pinnacle of healthcare. We can do better and we should, because birth control’s side effects are extremely dangerous. Disability is a part of this conversation. And you should never be afraid to pursue genuine medical help as a Catholic woman.

Looking forward to talking more soon about tools, gut health, PCOS, and comprehensive sex education.

Hug — Madison

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Categories
health PCOS

Bleeding to Death

My menstrual cycle has never really been private.

I got my period two months shy of my 15th birthday. It was my first time away from home, at the California State Summer School for the Arts (CSSSA), where I was studying, what else, creative writing. Thanks–no really, I’m so thankful–to a genetic predisposition towards excessive vaginal discharge (oh yeah, we’re going to be biologically accurate and extremely open. This blog is about the body, remember?), I had brought with me a stash of panty liners. But I certainly was not expecting blood. My mother drove from our Northern California town to Valencia with a day’s notice to make sure I was okay. She took me for my first pedicure, got me Chili’s skillet queso dip (which to this day is still my period food), and brought with her plenty of additional period supplies.

My being a “late bloomer” was, for whatever the reason, endlessly fascinating to my female extended family members. My mother comes from a large family of sisters who all, from around the time I was 9, expressed a deep interest in my physical development, frequently commenting on my cystic acne, flat chest, absent period, and even the changes to my “beautiful blonde hair” acquired throughout puberty. These conversations left me feeling like a concave, bloodless alien with pepperoni skin.

During my time as a freshman cheerleader, having your period during practice or a travel game meant swapping pads and tampons like you would swap bobby pins, hairspray, and Nars’ Orgasm blush. I never had anything to swap, and I was also never in need. Which meant I never had to worry about bleeding through my rolled-up skirt, but I also felt even more like the odd one out. Which I already was! I missed cheer camp for creative writing camp that Summer Of The Period. Coach benched me for the season. I went to every practice and then sat in the bleachers every. single. game. You know it’s bad when the mean moms feel sorry for you, a daughter who is not theirs.

I think, without these competitive pressures so often found in groups of female family and friends, I wouldn’t have felt so alien without a period. My mom regularly reminded me, as I cried to her about my body, that she too was a late bloomer. And, wouldn’t you know it, I do take after her in almost every way.

Except one. My periods were dangerously heavy.

Nobody really tells you what to look for when it comes to period blood. You can estimate colored-in red drops on the side of the tampon box. But clots, color, and sheer amount of blood are all indicators of health. So what’s the line between regular heavy and dangerously heavy?

I certainly didn’t know. From the time I started college, at the height of my ice snacking (read the Series Intro if you haven’t yet), my period was heavy. I regularly bled through a maxi pad or super tampon in under two hours. It was the norm to use both, and to change them both every four hours. I was spending upwards of $40 a month on period supplies. Fortunately, my periods were a normal length of days.

Even with my incessant ice chewing and constant washing-of-soiled-undies, I never once thought anything of it. I assumed this is what having a period was. In fact, I also never had cramps, so I considered myself lucky. I can remember telling people my period was easy.

There is something in here about how women are conditioned. We are told women have higher pain tolerances, that women mature quicker, that women are naturally strong because eventually they will undergo childbirth. It becomes how we encourage one another. It becomes a point of bonding. Women are strong. But that doesn’t mean we have to be every moment of every day.

The strength is often silent. Menstruation is often private (unless you too have a hoard of aunts who ask you every holiday whether you’re bleeding yet.) We sneak pads from our backpacks to our back pockets in math class hoping the boy seated behind us doesn’t see. Even older women strip their blood-stained sheets from the bed in embarrassment, thinking they ought to have known better, as they toss them into the pile with the clothes of the children they birthed.

It is all exacerbated in Christian circles. We are raised gazing each Sunday at a cross of holy bleeding. We are told to offer up our sufferings, and consider the ways our blood aligns us with Christ. Rather than share with our communities the ways we are hemorrhaging, we are told to only share it with Him.

As I tried to make sense of this connection between bleeding to death and theology, it occurred to me to reach out to my dear Catholic UChicago Divinity friend Rebecca MacMaster, whose current major project is on what she’s calling “Menstrual Theology.” I reached out for her thoughts, and here’s what she said:

“In some ways there is nothing more Catholic than a woman in pain. Jesus was brought into this world by a woman’s anguish. Our feminine mystics chastised their flesh and mortified their bodies, seizing in pews and genuflecting in small cells. Our feminine mystical saints starved themselves, ridding their bodies of a monthly flow of blood while rending their flesh to create a new one. Their work was salvific, unimaginable and yet eminently imaginable.

“When I started my research into the hemorrhaging woman in Mark, I expected to read about her bleeding. I thought it would be wall to wall articles about her body and her pain and her faith. But that’s not really what I found. Instead most focused on purity laws — often warping Leviticus to further an anti-Semitic agenda. Those who mentioned her bleeding focused on the healing, often claiming that she became instantly menopausal under Jesus’ touch.

“The message seems clear, there is nothing in menstruation that could be for the greater glory of God.”

“To be honest, my bleeding has never felt salvific and neither has my pain. I remember dim afternoons clutching my stomach and begging God to make it stop, like Jesus pacing alone in dark Gethsemane. It felt perfectly normal and yet also unspeakable. Too ordinary but also too gross for discussion. It just was. Some cramping is normal, take an Advil. That’s all I learned in health class. Nothing worthy of a doctor’s attention let alone God’s.

“But God heard the hemorrhaging woman and He healed her — not to menopause I would argue but to a place of healthy menstruation. There is always room for the glory of God.”

Hearing these brilliant thoughts from Rebecca (who you can find here on IG), I felt things click into place. I was all at once reminded of the exact type of messaging and friendship I longed for as I navigated puberty: One that was open with real, bodily experiences without shame, while speaking the truth of a loving God.

As I bled cups of blood each month, no one ever told me “You shouldn’t be feeling that way. You shouldn’t be bleeding like that.” In fact, the consensus seemed to be “no two cycles are the same,” “everyone’s periods are different,” “offer it up,” and “being a woman is hard.” This was all reassuring when I was anxiously waiting for it to arrive. And to a certain extent, it is all true! Periods are different! Being a woman IS hard! But, our periods shouldn’t necessarily be as different and hard as they are. Without open conversations about bleeding, women suffer in silence thinking their signs of reproductive trouble, and the lack of space for them in both religious and secular circles, are all “just the way it is.”

Sometimes we don’t even have our doctors to talk to! I spent one year on iron supplements to combat the iron-deficiency anemia that resulted from my heavy cycles. I even took additional vitamins to aid in absorption. One year later, when I got my blood levels checked, my iron levels hadn’t raised at all. Not one bit. In fact, they were lower.

It is here that I imagine many women will empathize: My doctor was not concerned. She did nothing to explore what could be causing my heavy periods. She did nothing to explore why my iron wasn’t being absorbed. She didn’t run a single hormone panel. Even as I sat crying in her office, she said I needed to eat more beef and spinach and sent me on my way.

And a month later I nearly died.

I was on a ski trip in Truckee one late January weekend with Guy, who is now my partner but was not at the time, our good friend Dana, and Guy’s best friend Austin, who at the time I did not know. I was not expecting my period for another week, but on the drive up the mountain, I began to bleed. And I did not stop.

It was like an open, gushing wound. Constant blood loss for 36 hours. I was passing clots the size of my fist. I had brought with me a week of period products just in case, but even that was not enough. I exhausted Guy’s mom’s stash of maxi pads from the 80s in one evening. I went through 30 pads and 7 tampons in 24 hours.

All the while, I was trying not to draw attention. Friday night I simply went to bed early. Saturday I decided to mention my period had started, so I wasn’t feeling terrific. We played in the snow. We cooked and watched Star Wars. By Saturday evening, I was going to the bathroom every 20 minutes. I finally had to let all three in on the fact that I was bleeding nonstop and thought I needed to see a doctor.

It was actively snowing and the streets wouldn’t be plowed until early morning. We could’ve called an ambulance, but they might not have been able to reach us either and it felt too serious for “just a heavy period.”

I felt dizzy and faint. I ate a granola bar in case my blood sugar was struggling. I couldn’t lie down or I’d stain whatever I sat on. I was too weak to stand in the shower, so Guy made me a bath that quickly turned to sitting in a pool of my own blood. I was freezing and couldn’t get warm.

Around midnight I went to the bathroom and as I got up, collapsed and blacked out on the bathroom floor, pants around my ankles.

I did come to, I cleaned up the floor, and I quickly expressed immense gratitude that I had not hit my head or otherwise injured myself in the fall.

Nobody slept that night. We drove back down to our college campus at 5am Sunday morning. It amazes me that I felt well enough to be taken to campus. I sat in my dorm room and made an appointment with my “eat more beef” doctor for that afternoon. Unable to walk across my dorm room without losing my breath and collapsing, I still thought myself alert enough to drive myself home to my parents’ house. I even lugged my hamper full of dirty laundry alongside me, without second thought of its weight.

On the way home, my doctor called back and told me to go to the Emergency Room instead. Something had come up, but she was worried about me. My mom met me in the ER.

That’s when the reality of the situation became very clear. I was taken into triage where the nurse drew blood, turned sheet white, and stated in no uncertain terms that she was “extremely happy I came in.”

I had lost a third of the blood in my body.

I stayed the night in the hospital where I received three separate blood transfusions. (I also received an incorrect dosage of intravenous potassium. I was in so much pain from the corrosive liquid I couldn’t sleep a wink. The morning doctor simply rolled her eyes and said, “they shouldn’t have given you that.”)

By Monday morning, while I had regained full blood levels and every ounce of desire to chew ice evaporated and is still gone to this day, we still had not discussed what caused the bleeding. I was visited in the morning by the on-call OBGYN who quickly prescribed me–and every woman knows what’s coming– the birth control pill (which will be the topic of the next PCOS series entry.)

The experience was not immediately scary while it was happening. Again, there was still a large part of me that was convinced this was just how periods were. It was only once I was in the hospital that I realized how deeply, deeply fortunate I was to be alive and healthy, with all organs intact.

This is the beginnings of my offering to the budding online discussion about the nitty gritty of periods. Especially in Christian communities that celebrate modesty and privacy, we are comfortable speaking in general terms about cycles, in the context of fertility only. We echo the general culture’s displeasure with red liquid in tampon commercials. Men and women alike still joke about how women go to the bathroom in groups, with very little consideration for how deeply biological the vulnerability of bleeding is for animal species like us. It’s not for talking sh*t about whoever isn’t in the bathroom with us, it’s about needing someone to clean and pin up my white winter formal dress because I bled through the bottom hem and can’t reach it on my own. We laugh about the women with severe PMS and how inconvenient it is for those they are around. But we still don’t talk enough about quantity or quality of period symptoms: Blood, cramps, clots, mood swings, aches, fatigue. The number of women who have reached out to me over Instagram to ask what signs and symptoms informed my PCOS diagnosis makes me all at once hopeful and sad: So many women lack information, community, and trustworthy medical care. So many women are fed up and paving their own way outside the doctor’s office.

One of these newest, way-paving resources is the online women’s forum femUnity. You can visit their website or find them on IG here. FemUnity provides a constructive, community-focused solution to panicked symptom-searching, led by women for women. Both their forum and their social media presence center on crowd-sourced information of real-life experiences, to paint a picture of the many possibilities and intricacies of women’s health, both reproductive and otherwise. I highly encourage you to check them out!

So yes, everyone’s period is different, but I’m going to lay out the things I wished I’d been told (informed by facts I’ve received from practitioners I’ve worked with post-near-death-experience.)

If you bleed through a maxi pad or super tampon in less than 4 hours, you should talk to a doctor.

If you need to use both at the same time and still bleed through them in less than 6 hours, talk to a doctor.

If you go through more than 8 period products a day, talk to a doctor.

If you pass clots larger than a quarter, talk to a doctor.

If you experience cramps that are not alleviated by traditional ibuprofen or acetaminophen…

If you experience mood swings or feelings of anxiety or depression outside of 2-3 day windows at the start of your period…

If you experience any of these period symptoms outside of a 7-10 day window…

Talk to a doctor.

I know it’s not always that simple. I know that doctor might not listen. I know I can say “talk to another one,” and that might not be an option for you (it wasn’t for me until I had access to my university’s medical center while I got my MA.) I know doctors with online practices have put their expertise behind giant paywalls. It can be incredibly frustrating pursuing a diagnosis. I believe you. You are doing your best. You are not failing because you can’t find an answer. (I will be providing a list of the resources that have helped me later in the series, but even then, if they don’t work for you, you are not failing.)

If you do talk to a doctor, you might think, “Madison, what do I say? What do I ask?” I would suggest…

1). Asking for a blood test that includes a “comprehensive hormone panel.” They’ll look at estrogen, progesterone, luteinizing hormone (LH), follicle stimulating hormone (FSH), testosterone, cortisol, and more!

2). Asking for a pelvic ultrasound

3). Making sure you’re current on your yearly physical exam and pap smear. In many cases your primary care provider can do it, you don’t necessarily need to have a designated OBGYN.

Beyond that, my biggest suggestion is to talk to the women in your life whom you trust about your period. If something feels odd, ask someone in your life if they experience it too. If they say no, don’t take that as a point of shame but a point of motivation! Keep asking.

How did I know to do these things? I’ll share my list of PCOS tips, tricks, and resources soon. I didn’t know to start looking for these things until much further into my journey to a diagnosis. Coming up next we’re going to talk about my experience on the birth control pill, then we’ll talk about how it has intersected with my gastrointestinal health, and then about PCOS resources and how it all intersects with family planning.

If you’re struggling with your period: You are surviving. You are doing your best. Your body knows what to do and how to keep you alive. Christ loves you and personally cares about your healthy bleeding. I am always here to chat. <3

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