Right now, this is the schedule for the rest of my fertile life:

1. Discontinue birth control use (one more week).
2. Begin Lupron, 6-12 months.
3. Low-dose progesterone-only birth control (such as Depo Provera) for a maximum of three years.
4. Have children, as close together as possible.
5. If symptoms return, hysterectomy.

…. all which will likely happen before I reach the big three-oh.

Lupron is a treatment which essentially induces premature menopause. It regulates a woman’s hormones, keeping them artificially low. Which means I’m going to be going through hot flashes and night sweats at the bright young age of twenty-two. You know, they already say fibromyalgia instantly ages the body twenty years…

That is done for six months, unless symptoms return immediately after it’s stopped, in which case it’s continued for another six. During that time I am going to have to have my bone density regularly monitored because I will be at high risk for osteoporosis.

After that comes the Depo, which I can’t use for any more than three years, because at that point the risk of osteoporosis begins rising. I could use a low-dose oral contraceptive pill, but even Mircette (the one I use currently) contains 20mcg estrogen — and estrogen is the hormone which inflames the endometriosis, so we’re wanting to avoid that if at all possible.

Then kids. If we don’t have trouble conceiving. If pregnancy doesn’t turn out to be too hard on my body, or even outright dangerous. If I can handle birth. If I can handle raising a child — much less two or three. If. If, if…

By this time, I’ll be in, what, my late twenties? Letting my cycle take its natural course (which, uh, is rather required if I want children) is only going to inflame the endometrial implants, because my estrogen levels will be that much higher.

Hopefully the Lupron will shrink them enough that it isn’t a concern for me anymore. They are, after all, not large, just very diffuse. But there’s already scar tissue that’s pulling on the back of my uterus and lower bowel in several places.

But if I’m not so fortunate, and my former symptoms return (I can’t afford to be indisposed for several days at a timeif I’ve got kids about)… pretty much my one option at that point would be to remove the uterus altogether. I won’t be able to return to something like Depo, and again, the low dose OCPs have still been inflaming the endometriosis over time, low dose or not. And the average age of menopause is, at current time, fifty-one. That’s a full twenty years — twice as long as I’ve even been fertile so far.

This is just overwhelming. I don’t know if I can handle it.

I’m used to the fibromyalgia and even my anxiety — I’ve come to a point where I understand them, for the most part, and I’ve found a good pace so that I can manage them effectively. But both are, for better or worse, conditions that are “all in my head,” by conventional wisdom. And, for better or worse, I’ve internalized that. I know that they’re all too real, and can be outright disabling if I don’t manage them correctly, but I know that most people don’t really understand either condition and are more likely to dismiss it than try to learn.

But this? This is real. It’s detectable. I have the pictures to prove it. And unlike the other two conditions, which are disabling in a nebulous, hard-to-explain sense, this is a disease that can fuse your organs together. That shit is just fucking scary, I’m sorry.

I’m not used to this. Not at all. I was on knife’s edge for the last couple days, and though the angry irritability has calmed down now, I’m still… unsettled. Very.

Here’s an interactive question (as soon as I fix Haloscan — sorry): Who else can you think of in history who’s been greatly maligned for actions or comments that aren’t, in retrospect, bad at all? (See previous post; Wright, Jeremiah.)

Jerry Falwell and his cohorts can damn America for allowing teh gays to exist, going so far as to call natural disaster upon the land — calling for the destruction of the country. The most that happens is a roll of the eyes.

Jeremiah Wright says “God damn America” for its horrific treatment of blacks throughout its history, and the entire nation erupts in a fit.

I understand “God damn America” is the most blasphemous thing a person can say in this country (moreso than damning God himself, it seems), but most Americans seem perfectly comfortable with the concept, so long as the damning is based on their version of immorality.

But when a black preacher is calling out a nation for something that most people, even the most conservative, agree is plainly sinful — the enslavement and continual discrimination against people of color in the country — we all get our dainty fee-fees injured. Even the left seems to be largely in agreement that what Wright said was loathesome.

I don’t get it.

Look ma, on time!

Mitsy has a favorite toy. It’s a furry little rattling mouse. And I threw it in the box my new pillow came in (fifth time’s a charm — not the softest thing in the world, but finally I banished the insufficient-neck-support headaches).

Buddy gives it a try:

And then reverts to his default position.

A different box.

It takes a cat to find a way to play with a chair.

…. and then get tuckered out and fall asleep on it.

It’s Friday in another dimension somewhere, I’m sure.

Apparently, quite a bit of endometriosis in the ol’ torso.

Of course, the insurance for which I am eligible as of Monday is trying to tell me they won’t cover the exploratory procedure which just diagnosed this, today, Friday, telling me it was a “pre-existing condition.” Apparently now they can just point at anything that goes wrong and say “HAH! Pre-existing! We won’t cover it!” Fuck.

Too bad I don’t have $299 sitting around to purchase it with.

Holly at Feministe is fighting the good fight against a rather strong current of opposition.

The Bootstrap Myth
“Racism is a thing of the past… this is a free country, and anyone who works hard can make it in America.”

The Backtrack
“Hey, wait a second, that’s not what I meant… I mean… you took my words out of context, don’t make it try to sound like I’m racist!”

The Remove the Right To Be Angry
“You’re too sensitive… if you weren’t so aggressive, vocal, hostile, angry, or upset, people would listen to you and you wouldn’t get in trouble!”

The Utopian Eye-Gouger
“I’m colorblind, personally… why can’t we all just ignore race, it’s not like it’s even real… it’s not like I tangibly benefit from being white every day or anything! Can’t we all just get along?”

Turning the Tables
“You’re being just as racist against white people, you realize. You’re being racist against me right now, you reverse-racist hypocrites!”

The Good White Person (not like those obvious racists!)
“Whoa, that guy over there is SUCH a racist, unlike me… I know exactly the right things to say and I’m never racist. By which I mean overtly offensive about it. Hold on, I think I’m going to go spit on that guy. I hate him.”

The Unblemished Family History
“Hey, my family never owned slaves, so it’s not like I, as an individual, get any benefit from racism!”

The Bending Over Backwards (makes you look flexible, but accomplishes little else)
“You people of color are so right. I agree with everything you say. Because you’re right, of course… not just because I’m guilty and white and wrong!”

The Personal Justification
“But a black person, Mexican, mean old Asian lady, or Native American once cut in front of me in line, said something stupid, mugged me, or took my hubcaps! So as far as I’m concerned, they proved all of my prejudices!”

The Loophole of Escape
“I can’t possibly be a bigot or a racist… I’m part of the oppressed due to the fact that I’m a woman!” (or gay, poor, young, trans, etc.)

The Culture Appropriator
“Damn, bro! You know I’m down with the homies, I ain’t no wack racist cracker, shiznit.”

The Lean On You When I’m Not Strong
“Teach me, help me. I’m just a white person, so I need your wisdom as a person of color to show me how not to be racist. Wait, is what I said earlier racist? How about this shirt I’m wearing? Can you come with me to this party, so they know I’m not a racist?”

The Pause for Applause
“Unlike all those other white people out there, I’m an anti-racist.” (…) “I do anti-racist work and I try to educate other people about anti-racism.” (…) “Wait, did you hear me?”

The Smoke and Mirrors
“I totally agree. Racism is one system of oppression among many interlocking ones, that specifically awards more privilege and power to all white people, whether they like it or not, and serves to keep the existing power structure in place. Oh… what? You want me to volunteer in a community organization, contribute money, do security for your protest march? Uh… yeah maybe next time, I’ve got to wash my hair tonight. And walk my dog, see the latest episode of Lost, manage my stock portfolio…”

The Penitent Paralysis (will not truly absolve you)
“Oh my god… that is so awful. I’m so sorry. Sorry. I can’t imagine what it must be like… I’m sorry. That’s so awful. I feel so bad for you. Sorry.”

Whipping Out Your Best Friends
“Hey, I’m not a racist, OK? Some of my best friends are black. See?”
Best Friend: “Yeah, I’ve known him since we were kids, and he’s never said anything racist to me!”

…and one bonus one for all your folks of color out there.

It Doesn’t Matter What Comes Out of My Mouth, Just Look at My Skin
“What? I can’t possibly be racist. I AM a person of color. How can I be racist against myself, huh? No, I haven’t heard of internalized racism, and I still think affirmative action is reverse racism!”

The people in comments are doing a hell of a lot of maneuvering, too.

People seem to be taking this rather personally, because it doesn’t offer an out for the “good” people. The non-racists. It implicates everyone, even those with a heightened awareness of racism.

Thing is, those non-racists? There is no such creature.

Holly continually points out that looking at the situation this way is dangerous. When we frame racism as the actions of individuals, as a character judgment, this is where we end up: we can’t own up to an attitude or behavior as being racist because, you know, it’s not dressing up in white gowns and forming a lynch mob. It allows us to separate out us good people from those nasty racists, who are way over there, nowhere near us, nuh uh. It allows us to absolve ourselves of any responsibility for our participation in the institution of racism.

We need to make this clear: Racism is not a character trait. Racism is a SYSTEM.

Racism is the tea in which we are all steeped as children. No person can escape it. Racism is clutching your purse when a black person walks by; racism is managing your investments in Quicken. Racism is mocking a person as stupid by affecting an “ebonics” voice; racism is sticking to the safe neighborhoods when you take your children out trick-or-treating. Racism is hiring a Mexican maid or landscaper under the table for low wages; racism is staying at a hotel that employs same. Even if you didn’t know it and didn’t intend it.

Makes you feel squirmy and defensive, doesn’t it?

You cannot escape this system. And the fact that you think you can bespeaks your white privilege in itself: no black person can escape the system where the taxi passes them on the street. No Latin@ can escape the system where they are assumed to be dumb and illiterate until proven otherwise. No person of color can escape the system where their resumes are passed up because of the explicitly ethnic name at the top — where research proves that employers would rather hire a convicted felon with white skin than a person of color with a clean slate and the exact same resume.

The fact that you think you get to escape that system, just by saying the right things, is, frankly, an insult to the people who struggle against that system every day.

Don’t take this as saying “therefore, you are a Bad Person.” Because this isn’t about who is Good and who is Bad. We all breathe the same air; you aren’t bad because you take in some random gases along with the oxygen when you inhale.

But there is hope. Because when you stop viewing racism as an individual character trait, and as an all-encompassing system that none of us can escape, then you start to see how things can change — really change.

You start to see that even though you do contribute to that racist system, you can reduce your contribution as much as possible.

You can start examining that privilege you’ve got.
You can monitor your language for slurs and dogwhistles.
You can attempt to change the latent attitudes you didn’t even know you had.

And you can start taking action. Knowing that this isn’t because you’re some saintly Good Person, but because it’s just the proper thing to do.

I myself use plenty of those Sixteen Maneuvers. We all do, really. It doesn’t mean one of us is worse than the other. It just means we all grew up in the same world. And maybe, then, we can stop turning it into a holier-than-thou competition, and start working together to make things better.

I stopped at the scale, put down my purse and slipped off my shoes. “So you know what to do,” the nurse laughed. “I’ve been to plenty of doctors in my time” was my reply.

When she asked me if I knew how to do a clean catch when sending me for a urine sample, I responded in the affirmative, and repeated as I walked to the bathroom: “I’ve been to plenty of doctors in my time.”

And that I have. I have myriad health problems, and have had since childhood. As far back as I remember, I missed no less than 10-15 days of school per year — and that before puberty kicked in and I found myself unable to sit upright on the first day of menses. I was always getting “sick.” Thing is, I rarely had a sniffly nose, an upset tummy or a fever. Usually, I was just exhausted.

My doctors struggled to come up with an explanation for this bright but languid child. I was diagnosed with fibromyalgia at twelve mostly because my mother began specifically asking about it. (I was diagnosed with a 20/200 left eye at the same time — no one had ever discovered my impaired eyesight.) I did a lot of doctor-hopping throughout my childhood and teenagehood. I found out that most of the doctors in my area were fairly ignorant as to my condition and had no real help to offer. I didn’t get effective treatment until I started traveling four hours to Beverly Hills to see the rheumatologist who shared the office with my mother’s, who is world-renowned for his work with fibromyalgia patients, but wasn’t accepting patients as young as I at the time.

That office watched me grow up. I traveled with my mother every 2-3 months for her appointments with Dr. Silverman, and then I started traveling down there every 2-3 months for my own appointments with Dr. Silver. The nurses were well familiar with me. They watched me grow from a lanky barely-pubescent child, always silent and hiding in the corner with a book, to a tall, lanky young adult, growing more confident and certainly more talkative.

And they took care of me. They listened to what was going wrong with me, and they understood, and when they told me what they thought, they knew what they were talking about. Dr. Silver was never afraid to explain recent research to me when I would bring it up. We could have a two-way conversation without me feeling condescended to. And largely, he recommended treatments that actually made a difference in my quality of life.

That kind of doctor is rare. I’ve spent more time in the offices of doctors who had poor communication skills, little knowledge of the condition at hand, and poor bedside manner than I have in the offices of doctors who were understanding and accessible and had relevant advice.

There was the doctor who dismissed my concerns about endometriosis as PMDD, primarily a mood disorder, when the only symptoms I had presented were physical, and so severe as to be disabling for the full week every month. There was the pediatric rheumatologist who would poke and prod at my tense and tender shoulders, repeatedly, every visit, exclaiming how tense they were. There was the county psychologist who marked me down for substance abuse when I listed Vicodin as part of my prescription list, even after I explained my disorder and offered to have her call my doctor for confirmation. There was the Pennsylvania doctor’s office who consistently denied me prescription refills or otherwise put obstacles in my path, and whose doctors I had to lecture on what fibromyalgia is because they were still relying on information from decades ago. There was the rheumatologist who yelled at me for a full forty-five minutes about how fibromyalgia is actually depression and the medical community was conspiring to put him out of business, and then felt me up (“just checking your liver” — which has what relevance, exactly?) before I actually ran out of the examining room, grabbed my dozing husband and broke into tears outside of the office.

And then he charged my insurance just short of $400 for the visit.

And that’s just a sampling.

These experiences make me all the more grateful when I finally have a positive encounter with a medical professional.

I asked my husband to come with me to my appointment yesterday. I remembered sitting alone in that dark, closet-sized room for twenty minutes waiting for the doctor to examine my sonogram results and tell me whether the lumps I had in my breast were cancer. It was excruciating, and I didn’t particularly feel like going through it again.

And when we walked out the door, I sighed to him, it feels so good to have someone actually take care of you.

I have been seeking diagnosis and treatment for my dysmenorrhea for four years. I’ve been suffering it for about a decade now. And now, only just now, I have someone actually doing the tests required to find out what is causing it.

My gynecologist listened to me while I described my symptoms. She asked questions to clarify. She explained her thoughts to me without condescension.

We’re going to rule out infection first, she said, and then if everything comes back negative, we can schedule you for a laparoscopy to check for possible endometriosis.

I can’t begin to describe that overwhelming sense of relief that hits you when you hear those words. Someone understands, and they want to make sure you are taken care of. They aren’t looking for ways to dismiss you or pass you off to someone else. That pain you’ve been going through for all this time, and all those other doctors who just shrugged their shoulders and showed you the door — someone is actually taking you seriously, and believing you when you describe your symptoms, and caring enough to follow through and make sure that it is correctly diagnosed and treated.

Someone is doing their damn job.

We scheduled a laparoscopy for next Friday. It is, thankfully, a fairly minor surgery. But hopefully, by that afternoon, we will have an answer.