exactly that

Archive for the ‘health’ Category

If Only It Were Real…

My brain has been staging what I believe to be a very violent coup for the last couple of days. I have a hunch that it involves an exit of some sort from somewhere around my right eye. Oy, my stars it hurts, and Great Loving Ceiling Cat I have been tempted to help it along over the last day or two.

Pain drives to you ends that you wouldn’t normally be willing to seek. Even more interesting, I discover as I move through some of my worst days, the fear of pain can be just as motivating, as I find myself in a panic, sometimes losing my cool at the pharmacy when being told that my script for one thing or another needs to be delayed or can not be filled as per my doctor’s directions due to one policy or another. Fortunately I have been through several meetings with various administrators at our hospital about the “singer provider” programs, which I know to be nothing more than devices contrived to catch drug seekers, so I survive in the web of rules. Barely.

Not everyone knows how to navigate the system as I do, to ensure providers that they are legitimately living with chronic conditions requiring actual care.

But still, I find that even with all of this administrative understanding, and one offer to be a Patient Advocate for my eloquence and fierceness of fighting for patient rights, I still find a simple thing like filling a prescription that allows me to live my life in a manageable manner a trying affair.

My doctor attempted to write my script to allow me sixty days of medication, both because it would allow me to not have to come in every three weeks, and because our evacuation books require it. The hospital pharmacy and the policy won’t allow me to obtain this much at one time. Only thirty days, and that is it. The pharmacist took the time to tell me that the policy could be set aside if I had a real condition, like a seizure disorder, but not for me.

Funny, because my medication is specifically approved for my specific condition, which is a pain disorder, and going off of my medication for even one day causes a relapse of that pain, and side effects that aggravate that pain.

I forget, though, that pain is not a real condition. Not one to be taken seriously, anyway. When I complain to the doctors about my migraines, almost certainly they tell me it is because I am taking too much pain medication, and I am experiencing snapback. But I am using the pain medication only for the migraines, because I have so much trouble getting it for anything else, and have to squirrel it away just in case of migraines. It’s a cycle, and one I am sick of explaining away.

It’s the reason that I have become adjusted to living with a certain amount of daily pain, that I hardly notice how it affects my daily life, so that when I get something abnormal, like a migraine that a normal person would consider a level “7” or higher on a pain scale, I rate it a 6 (it’s super legit, right?), but really I think I may be experiencing the Stigmata, pound it with some pain meds, and try to sleep it off. I crack jokes about how it feels, about how I want to jump out a window or how I understand how someone one thought that drilling holes in heads actually cured headaches. I skip using pain meds on days I probably should use them so that I can use them more on high pain days. The migraine blinds me, it makes me see stars, it makes me dizzy when I stand, but I stave it off and push through with as much as my stomach can handle.

Then, the doctors and pharmacists can be kind of right, due to the stringent rules they set up.

It seems that pain is to be treated as if it isn’t real, and that those of us who live with pain are simply poor, suffering drug seekers.

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#DearJohn: Military Women, Civilian Women, Shouldn’t Have to Justify Their Choices

You may have heard of this act that is attempting to sneak its way through Congress right now, with my new BFF John Boehner (don’t worry, Elaine Donnelly, I haven’t forgotten ya! XOXO) taking up the gavel as the 2011 model of Speaker. If anyone were to ask my opinion, I would say we have gone from a nice comfy, family SUV that maybe didn’t always get us from point A to point B but worked out OK, to a gas guzzler that doesn’t have enough straps for car seats. Not family friendly.

Our Dear Mr. Boehner is trying to do to civilian women living in the U.S. what has been going on with U.S. servicewomen for a very long time, as well as woman and girl family members. For all the hemming and hawing I hear about how the military enjoys its great free health care (I don’t know how “free” it is, because we certainly earn it), I think that a lot of people don’t realize how limited the choices of that health care are for women.

Just last year women in uniform and their families were able to guarantee that they could access the emergency contraceptive pill known as “Plan B” in the U.S. at every military treatment facility world wide. It is now part of the formulary, or the list of medications that must be stocked wherever medications are stocked. And everyone over the age of 17 is able to get it over-the-counter as long as they have a military identification card.

But abortion is another topic altogether. And while the fight is going on at home, I think it might be a good time for those of us in social justice who have a hand in the fight for reproductive justice to know a few things about the access to abortion in military facilities.

While the “No Taxpayer Funding for Abortion Act” is trying to hack away at your reproductive justice, our reproductive rights have been held hostage for a long time. Since 1979 to be exact. That is when Congress decided that military hospitals would not be allowed to provide abortions except in cases of rape, incest or if your life was really, really, in danger. That last one there is totally up for discussion, because it is really up to whatever doctor you get strapped onto to decide to declare if your life is in danger. And “abortion” is anything from evacuating an already still fetus that is causing you to start running an infection to an abortion that could allow you to start a treatment like dialysis or cancer treatment. The doctor’s word is the final say.

If you are a rape survivor who doesn’t wish to disclose the crime committed against ou to anyone and ou wind up pregnant, you are out of luck. No abortion for you. You not only have to admit you were raped, but finger your rapist, prove you were raped, and then maybe you can have your abortion. Oh, but you still have to pay for it out of your own pocket. Given the rate at which rapists in the ranks are actually referred for NJP (hint: it’s small — about 10%) and the threat of ostracization from peers, I don’t think that it is any wonder that some women have tried to take things into their own hands rather than go that route.

In the U.S. it is all hunky dory for some servicemembers, because there is a chance that you can access an abortion clinic or other facility that will accept your insurance or that you can afford. But if you are stationed in a country where abortion is outlawed, such as Iraq, Afghanistan, Djibouti, or even Republic of Korea, there is no off-base abortion access waiting for you. Instead, and holy Ceiling Cat I feel like a broken record, you must first obtain permission from your command and hope that they believe whatever excuse you have come up with, hope like hell you have funds for travel to the nearest country where it is legal, and that you make it all in a time-frame that makes it still safe and legal for you to obtain the procedure. All because you can’t even use your own money in a military treatment facility.

That’s right.

You can’t even use your own damned money to access an abortion if you are in the military and stationed overseas.

We keep trying to get this repealed, and every time Republicans block this, because military women don’t deserve a full range of health care, even if it is equal to that of the women in the country they are representative of. They are not allowed to receive a safe and legal medical procedure that is available in their home country from a medical team already trained to perform it from that country.

We petitioned. We called Congresspersons. We asked for support from the social justice community. We tried. And when it came time for the vote, the chance for a change was stripped away again.

So I am not exactly surprised to see more of the same ol’ from our Dear Speaker Boehner, trying to pass this H.R. 3.

What I want is simple.

I want access for everyone. What I really want is single-payer access with a full range of services for everyone, but I will be realistic.

I want Boehner to stop telling women what ‘real’ rape is. I want him to stop chipping away at our rights. I want the reassurance that if I want or need an abortion I do not have to fly to Japan or all the way back to the States to get one, on my own dime. I want women to stop killing themselves because they are desperate to not be forced into being incubators.

And I want to work together with those of you who want to convince your Congresscritters that this is a good idea.

Call your Congressperson. Tell them that Speaker Boehner has no right to make decisions on behalf of other people’s bodies. That his contempt for the lives of women is showing though loud and clear with every attempt he makes at stripping our rights away.

But when you call, or write, or however you communicate with them, telling them that they should not strip abortion access away, remember to tell them that disallowing servicewomen, who are serving their country every day and facing unplanned or unwanted or live-threatening pregnancies just like their civilian counterparts, to access abortion by paying with their own funds is absurd. It is beyond absurd. Tell them that it is unacceptable. At least as unacceptable as stripping abortion coverage from health insurance, because that is what it has been to us — having a medical procedure stripped from our health care coverage.

Please. If we work together, I believe we can be stronger. We let Republicans strip, again, a bill that would have restored medical services to servicewomen and family members, and I believe that somehow they have it in their heads that it means that we don’t care enough to stop them this time. We need to tell Dearest Speaker John that he isn’t getting away with this.

Find the information for your Congressperson here.

Read about how your rape just isn’t rapey enough.

Follow the excitement on Twitter by following the hash tag #DearJohn, or tweeting your outrage to @SpeakerBoehner.

Sady and Garland Grey, thanks!

Medical Autonomy Chronicles: The Virgin Pap Smear

ETA: 18 Sept. 2010 After this post was linked at FWD/Forward in the RR, it was brought to my attention that this post possibly could be triggering to some people. This post should have a trigger warning for a graphic description of a medical procedure done on a young virgin girl. The procedure was upsetting to her, and the description could be potentially upsetting to readers who have had similar experiences or who have been sexually assaulted, or medically raped/assaulted. My most sincere apologies for not having the forethought to include this warning sooner, and to anyone whom this lack of thought may have hurt. ~OYD

Where did it come from?

A conversation starts about shaming in OB/GYN care, which is an important one.

Suddenly all of these people have flown out of the wood work to make sure that all of we lady folk know that getting our pap smears and pelvic exams is Just! So! Important! Medical and non-medical alike.

They need not even all be lady folk themselves, but experts who have lady relatives who have had their lives saved by paps, so they must impart to us the urgency to spread our thighs and allow ourselves to have invasive medical procedures that we do not want. Medical procedures that can be painful, traumatizing, and even, as has been show, unnecessary.

But there is a whole slew of thing that keep we peeps, and I say “peeps” because I am certain that there are people who do receive pelvic exams and paps who do not identify as women who may also feel bullied or forced into these medical procedures that they do not want as frequently as people feel the need to force us into them.

Why with all the pressure? Even when most of the information I found says every 2-3 years (I think it is worth noting that the Australia site is the only one that has information specifically for people with disabilities)? Even that information is varied. It seems that people, even medical providers pressure people to get paps every year. Especially if you want birth control. There seems to be this habit of holding birth control hostage if you are unwilling to submit to having a metal or plastic instrument shoved into your vagina and having bits of your cervix dug out.

Even on virgins. Oh, yes. In the U.S., for I can not speak to other nations, there is this fixation with making sure that doctors or other practitioners are the first ones to shove things into the genitals of virgins girls seeking birth control, whether or not she is seeking it for sex. Even though there are several good medical reasons why she could want birth control that don’t involve wanting to partake in heterosexual intercourse.

When I was fourteen, I was having period cramps from hell. I was bleeding like a stuck pig for three days straight out of ten. I would need to miss at least one day of school a month due to period cramps because I couldn’t get out of bed from the pain. Sometimes I would vomit from the pain.

Eventually, the cramping started coming when I wasn’t having my period. I was having cramping so bad that I was begging to miss school during this time as well. I remember my mother thinking I was a hypochondriac around this time of my life. She would sometimes groan, and often joke to her friends that I always thought something was wrong with me. I would often try to hide pain from her because I didn’t want her to laugh or make fun of me. She even had our doctor convinced that I was making things up. When I finally got in to see him, he chucked, and without really examining me, told me I had Mittelschmerz, and that what I needed was to stop coddling my body during my cramps and to get up and start being active during my cramps. This would not be the first doctor my mother convinced to laugh at my pain in my life.

So, I tried following his advice, and I would damn near pass out during gym class or band. The pain was so bad that I couldn’t eat and it would bring me to tears, dizziness, and I would dry heave. Finally my mother took me to the doctor again, who finally did an ultrasound and determined that I had large ovarian cysts that were causing me to have painful periods. I needed to see a gynecologist for a consult.

On top of being worried that anyone at church would think that I was having sex (because I knew so little about sex education at the time that I thought that the GYN was only for people having sex or babies), I was nervous. Incredibly nervous. I thought for sure that everyone thought that I had done something already and was lying about it. The gynecologist was the brother of my science teacher, and we were in a relatively small town. I was so worried that someone would KNOW WHERE I WAS. Also, that I was A LYING SEX HAVING SLUT!

Yes, I had cysts, and the doctor said that the best treatment was going to be to put me on the birth control pill (OH THE MORTIFICATION!) because it would help reduce them and ease my period. It was supposed to reduce my period and help them be shorter and lighter (let’s get this clear, for me this was a lie! I still have 8-9 day periods that are reminiscent of a butcher shop). He wanted to know if I was sexually active (OH MY GOD DID HE JUST SAY THAT WAS HE TALKING TO ME *FACE FLUSHING SCARLET*), and even though I said no, I had to have a pelvic exam and pap smear anyway, because that was routine procedure for prescribing birth control. (Wait. What?)

My mother had dropped me off and signed all the consent forms. How nice of her. I had no idea what was going on. What? OK. I guess so. What did that mean? You want to put WHAT? WHERE?

Suddenly this doctor, this man, whom I didn’t really know but looked an awful lot like my eighth grade science teacher, which made me really uncomfortable, was feeling my breasts, telling me that I needed to do the same thing in the shower (Uh-huh, OK, keep looking at the ceiling. That was nice of them to put a poster up there…). I had to put my feet in stirrups, which reminded me of riding horses as our friend’s farm, and certainly didn’t put me at ease. I was naked, and I had never been naked in front of any man who was not may Daddy trying to help me dress for bed, and that hadn’t been since I was about ten, and it wasn’t like this.

I was asked to slide down until I was squatting. There was cold jelly, and a metal thing, and even though he was talking to me through most of it, I remember the poster of the wooded lake on the ceiling, with the bridge over it, with one of those quasi-religious inspirational sayings on it. Suddenly I was being penetrated by metal objects and fingers…and it felt wrong and awful and I just was always told that this shouldn’t happen… not like this. Hot tears ran down my face. He asked if I was OK as he felt around inside me while pressing down on the outside of me at the same time. I could only nod, afraid of what my voice would sound like if I gave in to it. I don’t even know why they bother with gowns. They are laid open, and my whole being, my essence felt exposed on the cold crunchy paper. I didn’t know what to do with my hands. I shoved them into my hair, and pulled tight.

I didn’t know that doctors ever did this.

(The poster has a lake…are those birch trees?)

And it hurt. And he felt my ovaries to check for the cysts. And he took his sample…and it felt like a sample of my soul left me.

For all the talk of how having sex outside of marriage or whatever message had been pounded on me for however long, and how it would leave me hollow and leave me feeling worthless and damaged, and for all the ways I had been told that casual sex would leave me reeling and feeling depressed and with a hole of missing self-esteem, nothing I did in my consensual sex life has ever compared to the way that pelvic exam and pap smear felt to me, a fourteen year old girl. A person rising on the crest of womanhood, not yet there but ready to fly, and having had myself violated before I took my first steps.

I left that doctor’s office with a script in my hand and a hole in the depths of my soul and a hollow in my heart. I walked to my friend’s house, because I remember that my mother was on second shift. A long and lonely walk toting my French horn, the plastic molding of the case banging against my shin. They were the kind of friends that had become a second family to me, who kind of took me in as the kid who needed looking after sometimes and loved me intensely. I remember the mother, telling her where I had been and what had happened. And while I have never experienced what I consider sexual assault outright, I can imagine that this must be an ember of that fire. I cried, feeling dirty and awful and ashamed, as she held me.

My friend’s mother looked me in the face and leaned against the carved post dividing the kitchen, holding my face in her hands, as I looked into her angular face, with her short wavy hair, and her kind, almost smirkish smile that always had a way of washing comfort over me.

“Being a woman is Hell”, she said, which surprised me a bit, this being back in my church days. “Going to the gynecologist can feel as embarrassing as Hell, but it won’t always be so awful”. She hugged me against her shoulder, and brought me some Texas Sheet Cake, because it seems that chocolate could always help me calm down sometimes. Or maybe is was a combination thing.

I wonder if maybe it is a combination thing. If maybe I had been informed a little more and had an iota of a clue about women’s health care, and what a pelvic exam and pap smear is all about.

Or, maybe if things like pap smears aren’t forced upon young people who are not sexually active, or upon people who don’t want them. If we don’t hold birth control hostage. If we don’t do things like force people to the outside of their own health care, we might be more prepared. We need to set clear guidelines (OH WAIT! ACOG!) to make sure that folks know what doctors are expecting and what is actually needed, so they can be aware of what is suggested to keep them healthy. This “maybe every year, but it is really only needed every so-and-so years, but, hrmmm…we feel like doing it every two years stuff” isn’t cutting it. We have a right to know the guidelines, and to insist that we only have invasive medical procedures as often as needed. Not as often as someone else who is not us feels like it. Even Scarleteen, a site I love, is vague on the expectations of the requirements for paps and pelvics. We need our medical professionals to stick to what ACOG has laid out (or, in my case, I would like them to just be aware of what ACOG has put out before I am), so we can get a standard measure of care. ACOG has said the risk of being treated for a false positive is not worth testing every year.

Really.

When I see articles like this, I realize it is more about making sure we control women, who just can’t be left to their own medical decisions! They are all so silly! This isn’t about shaming women for being nervous or embarrassed (for very good reason). This is about understanding that people have a right to autonomy over their own bodies. Yes, even teenagers! (I know, I am so silly, thinking they might be people who have thoughts about their medical care!) And health care is a part of that autonomy. An important part.

Education, consistency, and plain ol’ listening to patients might help. Listening to women and people in general who have to have these procedures might be a step. Re-evaluating the reasons for insisting on them for simple things like birth control, especially for non-sexual reasons in virgin teenagers might be a step. Being more compassionate to people experiencing GYN care for the first time — or even in general — might be a step. Including women in conversations about their reproductive care might be a step.

But demanding, shaming, controlling, hostage taking of parts of care? That is not helping.

It could kill, and I venture to say it will do the opposite of what all of your concern-trolling of reproductive health is intending to do.

Kid had it right, learned it in Pre-school even: My face, my space. My body, my business.

Race, Disability, Ms. Magazine (Again), and Mythbusting the IUD

It happens every now and again. Someone writes something really remarkable. A post or article that is so full of win that I want to give it as much attention as possible. It has a ring of truth that many people don’t want to read, especially segments (HA! Segments. By segments, I mean most of feminism.) of feminism that believe that reproductive justice is a one-size-fits-all movement and that we should all snap-to and join together, because all of our interests are equally yoked in the fight. A strike of brutal honest fact that shows that some victory has been won, historically over the backs of others.

But then I read it and I see some little segment of non-truth, some swipe that isn’t as well-done as the rest that leaves me with a sour taste and I see it as equally harmful to some.

That can be said of this almost-home-run piece by Nicole Guidotti-Hernández at Ms. Magazine’s blog. It isn’t a secret that I have my share of issues with Ms. or their blog, like their ridiculous Obama as Superman cover or the recent blog post about how all us disabled folk were a hive mind of dupes working for the anti-choice movement. The difference being that Guidotti-Hernández’ piece was actually good. Solid. The reproductive justice movement, and feminism in general, has thrived on as marginalized women have laboured, forgotten. White women, rich, well-off women marched on to vote, enjoy their new freedom, and gain rights and non-white women nursed their children, and disabled women stayed in the corners forgotten as worthless and unworthy anyway.

Nicole had me until the part where she seemed to be dissing on IUDs:

Yet, I can’t help but think of a recent visit to the gynecologist (not my usual one, but an affiliate in the practice at the University Medical Center in Tucson), at which the doctor kept insisting that I consider an IUD even though I am unmarried and have no children. As a recently tenured faculty member with a hyphenated “Latino” name, this unwavering persistence that I need an IUD–or, rather, am a good candidate for one–and therefore not needing to reproduce, suggests that reproductive racism is alive and well, even for an Ivy-league educated Chicana. It makes me wonder how many other Latinas, educated or not, are being pushed to control their reproduction with this subtle racism that is the dark underbelly of reproductive justice.

I can sympathize with her feelings of frustration here. My own heritage is full of women who were forcibly sterilized. Perhaps what she senses was happening is in fact what was going on. I don’t know. I am not one to fully discount institutional racism. I know all too well what it feels like to feel like your provider isn’t listening to you, maybe even better than she does. There is no excuse for a provider to not listen to your wishes. It still doesn’t change the rest of it. It is also entirely possible that she had a doctor who was simply trying to give her the best possible birth control option for her, and that because she hasn’t researched the IUD properly, and that she is spreading myths about it, that she was dead set against hearing that it was that: a great choice for her. Having “Native American” stamped in my medical record didn’t make obtaining my one any easier. I had insurance on my side, and even my “white” appearance, getting me more than one odd glance when what they see doesn’t match what they read. I am forgetful with pills. I am horrible with getting refills. I have all kinds of complications that interact with hormones, and more reasons than fingers for doctors to dissuade me from having more children. And yet, I have had the opposite experience. Twice.

It is also no secret how I love my IUD. How I have had to fight to get it. Why is that you ask? Why did I have to fight to get it?

Because people seem to be caught up in the days when IUDs in the U.S. were getting a bad rap for still being dangerous, and it seems that most people — women, nurses, doctors, preachers, whathaveyou — can’t be bothered to pick up the latest literature and brush up on what is so awesome about IUDs, or so safe, convenient, affordable (for a privileged sect), and practical.

Modern IUDs, available in two forms: The plastic hormonal and the copper non-hormonal (Mirena and Paraguard in the U.S.). The thing is, they are not just for married moms of three kids these days. IUDs are also great for…well, almost anyone. No longer do you have to have popped out kids in order for your cervix to be right. Some doctors still believe otherwise, and I believe that if we continue to allow people to spread myths like the above quoted passage, they will continue to turn women away from this great form of birth control. Armed with information, doctors, nurses, and even *cough* nurse midwives, will begin to see that everyone’s cervix is different and that it depends on the woman, not her status of maternity.

Being married is no longer required either. It is more important to be smart and responsible about your sexual health than to be in a marital, or even a monogamous, relationship. I think people realized a while back that being married is no longer (HA!) proof that you will be protected from STIs. Many professionals recommend a second barrier method in conjunction with an IUD, but you would have to use that with the pill, the patch, and most hormonal birth control anyway.

IUD is about the most popular form of birth control in the world. In fact, according to Guttmacher, its use in Europe outdoes the other leading three uses of contraceptive in the U.S..

Why could that be?

Well, for one, if you opt for the Paragard, or copper version, there are no side effects. Once your body adjusts — most women experience mild to “oh my stars I want to ker-smash things” cramping the first month or so — you no longer have any of the brought-on-by-hormones deals that are associated with the pill, the shot, etc. Smokers, those with high blood pressure, heart disease, and even people like myself who have medical situations that interfere with the pill, can happily use the copper IUD.

Mirena offers a low dose of hormones with the benefits of being an IUD. An extra whammy if you will. Conditions like endomitriosis are believed to be helped slightly by its use. It is also believed to help aid heavy periods and can help lighten them. It won’t set off metal detectors at airports*. Slate has a good article that focuses on the IUD.

Both are easily reversible. By “easily”, I mean “almost instantly”. I mean, were I to go in to my doctor’s office today and have my Paragard removed, The Guy and I could, in theory, conceive a child within ten minutes of the doctor leaving the exam room. Long term doesn’t mean permanent. You don’t have to wait a month (or longer) for the hormones to leave your body. Many women in Europe and Asia use the IUD as an alternative to the more permanent sterilization at the end of planning their families. The U.S. just hasn’t caught on yet.

It is also ready to use the day (THE SAME HOUR!) you have it inserted.

The start-up cost is, sadly, higher than most other forms (between $300-$500 without insurance), but the maintenance is lower. “Lower” here reads as “virtually nonexistent”. Every other form of birth control requires you to maintain. The shot and ring: Monthly. The patch: Weekly. The pill: Daily. Condoms: Every damn time (no, really, you can’t re-use them, even if you wash them!). With the IUD, you have it inserted, and then you basically ignore it for five years or ten years, depending on your device (well, you should stick some fingers in there to check for the strings once a month or so, but checking your bits out is a good idea anyway), or until you decide to have it removed, barring any complications (and I am not saying there won’t be any).

There is no month-month cost, and if you are paying $60 a month in birth control, over the 5-10 life of your IUD, it is cheaper. In reality, I know that if you can’t afford $60 a month, you likely can’t afford $300, let alone $500, but this is the reality of the economics of the device. If you have access to a women’s health clinic, like a Planned Parenthood, they may be able to help assist. More VA centers are getting into the Women’s Health arena, with closed curtains and everything, but I am not holding my breath. IUDs are usually covered by insurance, but I am not going to pretend this is always the case. I know quite a few notable exceptions to this, which is why it is important for people to realize that reproductive justice issues are a part of women’s health care.

The reason attitudes like this irritate me is because even OB/GYNs and other women’s health professionals have a hard time paying attention to the good side of IUDs. The reasons for this, I am not sure, but it makes it damned difficult for people who want or need them to get them. Some people who need them, who can not use other forms have a hell of a time getting them, and not just because of lack of availability or costs, but because doctors just simply don’t keep up with the latest information (as I recently found out for myself).

You would think that its 99% + efficacy would be a drawing factor. Sure, studies show that the pill and patch and condom also tote these, but with perfect usage. Typical usage put them at closer to … not so much. Depending on who you ask, those methods are more or less reliable if you use them well enough. The copper IUD is has a less than 1% failure rate, and the hormonal IUD a pretty close second. That is the most effective birth control after abstinence. A couple of hormonal birth controls come close, but really, it is the most reliable.

It just irks me, irks me to no end, that amidst sharing parts of a dark history that needs to be highlighted that someone would mix in myths with their, possibly justified, suspicion. Non-white women have endured a long history of forced sterilization, and messages that we shouldn’t enjoy the same freedoms with our reproductive rights. That justifies the suspicion with reproductive medical professionals. I’ve had them myself. But it doesn’t mean that every time it is going to be that way, or that things like IUDs are suggested to keep our wombs closed forever, because that just isn’t what they do, and I will not sit idly by while someone writes a mostly good article, and while it is passed around passively and highly praised (albeit, mostly deservedly). But someone needs to point out the flaw. Someone needs to point out the dangerous myth. Maybe some young woman, maybe a young Latina woman, possibly with some sort of disability or need I can’t think of, someone who doesn’t want children while she completes an education, or doesn’t want a family and doesn’t want an invasive procedure like sterilization, might read this article and think that she has no other options. And specialists will only confirm that suspicion.

I can’t have that.

For more IUD love from a non-white perspective, see Lena Chen.

More of my IUD love.

*I had the surprising experience of my IUD setting of a metal detector at the Honolulu Airport while going to drop The Kid off for an Unaccompanied Minor flight. I had no metal whatsoever on my body, no clips in my hair, and a t-shirt on. The guards were baffled, that the wand was only picking up a crackle near my abdomen. They let us through and when I came back, it was the only thing that occurred to me. They agreed that it was what must be giving them issue. We all had a good laugh, and it cheered me considerably.

The One Where My Boundaries Were Also Violated…

Warning, this post if very rambly…

I went to a very whitewashed high school in the U.S.

My U.S. History teacher had a fucking shrine to Monticello in back of the room, and we learned about what a Great Guy Christopher Columbus was. He was seriously a hero.

We were taught that the Trail of Tears was a necessary means, and that the gov’t was Really Very Sorry for it.

Mad Ann Bailey was a Women’s History icon.

No one ever mentioned that my tribe was the only one to hold off the French oppression. In fact, most people have never heard of my tribe at all.

(You don’t “look Native”!)

I took the standard history I was fed.

I grew up scraping together pieces of my heritage because I only had parts of it to keep. I won’t rehash it because the people who know me know how difficult and personal it was to hold together and how fucking hard it is to assert my right to keep my non-white identity.

I can barely keep up w/ my own heritage and the emotional toll it takes on me, because discussions about race are extremely personal for me. Just because I don’t blog loudly and publicly about it doesn’t mean it doesn’t touch my life deeply on a daily basis. I don’t have to pass a litmus test to get cookies. I bake cookies if I want them.

So, I don’t think that I need to explain in great detail, that when I was enjoying an internet free day, while my partner, in my single computer home, was playing EVE Online and I was tucked into a great Space Opera novel (Spin, I recommend it), that shit went down that I was unaware of…

I didn’t check my email, my backends, or anything that day… in fact that email couldn’t have hit my inbox any more than an hour after that first angry comment went into the mod queue at FWD, which is a site that has a comments’ policy that clearly states that we have bloggers from four countries in several different time zones and that comments (all comments are in full mod all the time) can take up to several days to respond to or even approve. That first comment was given fifteen minutes time before the next came in, and then they rolled in again and again. On a website where the mods have disabilities and have to manage spoons that need to fuel their on and offline lives…

Then came the abusive — yes, abusive — comments asking if we didn’t have the spoons to deal with our racism… calling into question our disability status while many of us were sleeping or spending time with families or taking self care time. Something we have a right to do and that the internet has no right to take away from us. All within a couple of hours’ time… (but I hadn’t seen any of this yet) I would never dream of calling into question another person’s racial/ethnic or disability status when they have laid it out publicly so often…I would expect to get that shit called out quickly. That doesn’t fly in my playground…ain’t how we roll on my rez (OK, that is how they did roll on the rez, and maybe that is why I am so protective of people I love now, because calling that shit out is racist/ableist and I ain’t gonna do it)…

Then, Father’s Day was observed for us here on the base near where I live, even though we are currently living in the Republic of Korea, which I will point out is in the Eastern Hemisphere and in the same date and time zone as parts of Australia (you’ve heard of them, right? It’s another country, and continent), and we had plans to go out and spend some great family time together, after we finished up the grocery shopping. I made a list, and noted that the Kid is on school holiday, so I needed to incorporate home lunches for two into that, and was going to plan for home made bread which I remembered might be more fussy than my Korean oven would allow right now, with it’s temperature numbers missing, so I needed my Laser Gun (thanks s.e. for helping me choose!) thermometer, and decided that before I forgot I needed to really quickly close my Amazon cart…

I always leave my email open, but since we have multiple computer users Apple does this neat thing where we can have different screens running at once, and I used the “apple + left arrow” to scroll over to my screen to open a new tab and saw at the top of my inbox an angry email calling out myself and my fellow FWD blogger, Chally, for not addressing the issue of racism at FWD, since we were “POC”s and such…

That was the official moment that I learned what the fuck “Juneteenth” was. So, my ignorant ass had no idea that any internet crime had been committed. And suddenly I had to spend two hours derailing my family’s plans — because that is how OCD works — and had to catch up on WTF was going on. But our policy states that we have that long mod time to allow us to work on an international schedule and to make every attempt to contact the original poster… none of us can move unilaterally in this situation and I don’t know why the fuck this is still being explained b/c you all could read it if you were so inclined (which many of you are not or you would have)…

We have this in place to protect us from reacting too quickly and rashly to things, and it has been this way since the beginning…but I suppose it is less fun to read silly things like comment policies and intro posts than it is to run amok all over the internet w/ whatever information you believe is the truth and tear people’s lives apart — some of those people being people who have mental illnesses that are affected by this kind of abuse — there’s that word again — and create more page hits and fun bandwagons to endorse for yourselves…

Because I have read the posts, I firmly maintain that there was no fault at FWD. I think that Anna and s.e. didn’t need to apologize for shit — and I realize that this will be unpopular because everyone fell all over their damned selves to rally around the loudest person yelling — because the Helen Keller Blogswarm invitation was clearly an invitation to write about what was important to each of us, and about intersectional issues. The date wasn’t specifically chosen by FWD, but by a larger group celebrating a well known, international disability rights activist. If this meant that Juneteenth was important to you, then by all means, write about that. It would have been productive, and it would have been eye-opening instead of destructive. If I am accused of Tone here, fine. Accuse me of tone. But claiming that an invitation to write freely in any space in the internet about anything that you desire is erasure is disingenuous (so sorry you were caught doing some shit you shouldn’t have and this is how you reacted, but we didn’t deserve this kind of fucking abuse). At best, really. And more obviously a way to openly attack a group of vulnerable people by using the privilege of voice, platform, and popularity. Details are made up and twisted (comments closed specifically to shut down Black people? That is some incredible foresight to close comments on a personal blog months ago and to request the same permission weeks in advance!) and no one bothers to do the required reading before throwing a hat in the ring and trashing bloggers’ names.

But if I may: Making something All About You when it isn’t is awful. Someone I once respected taught me that. Once again, taking something that wasn’t specifically aimed at excluding an obscure U.S./North American holiday (but was intended to include it if any author wanted it to) and making it so, is selfish, so obviously a cry for page hits and fabricated drama, and once again centering a discussion that shoves people aside and silences voices that aren’t as popular or powerful as your own. Once again, this forcing of a race issue to be Black or White is erasing people who fall in between. Where is the outcry when Aboriginal/Islander/First Nation/Indigenous holidays get no attention? Where is this outrage when our people are misidentified or white hipsters appropriate our traditions? Sport’s teams our names as mascots? Where is the cry of racism when mixed ethnic people are labeled Black or White, and their identities erased? Where is the Day of Emancipation celebration for Indigenous people in the U.S.? (We don’t have one because we are not free.) Where is the freedom from oppression for PWD? (There is none!) These identities also intersect within my own body, both of those having extremely high instances of sexual assault that is ignored by law enforcement, placing bodies in situations where pay is cut/lower than livable, benefits are denied…the list goes on. And yet, instead of bullying anyone off the internet I was/am proud to be part of something that cherishes all voices and wasn’t working to hurt some in the name of my own singular, louder voice…

I am not going to ask permission for this one: I appreciate being tokenized about as much as I appreciate being erased. I have drafted and re-drafted an email response to that original email, before I gave up and realized that no response will suffice, especially after being publicly flogged for having the audacity to be offline with my family for days. I have a right to self-care and non-internet time. I have a right to value time with mine. No one can take that from me, as my body tried to take that from me, and as this abuse now tries to take more of it from me mentally, I will not stand for it as I now need pain pills to cope w/ the flares this added stress is causing.

It is equally racist to call me out because of my ethnic heritage and demand that I stand with you. Yes, “POC” can be racist too, and this action was racist. Expecting me to stand in solidarity (as baseless claims and hurtful half-truths were slung) based solely on my non-white status is a racist act. Telling a person to don white sheets is hateful abuse. Emailing me and expecting me to react instantly is a North American-centrist attitude, and expecting that I could/should respond while I was sleeping because you said so smacked of an attitude of colonization. Too many times am I erased because my color is not the right color, and finally, when it is convenient to you, I am expected to fall in line and fight, or be called a colluder. Fuck that.

I have a right to decide where I lay my loyalties, and I have decided that I stand with intersectionality, and with people who don’t need an Either/Or, because there isn’t a limit on pixels or tube space. We can have all of it. We can share the space and overlap our margins, and that is what I am striving for. No one gets to tell me how I use my spoons or what battles I fight. I resent being chided like a child, as if somehow I can’t understand my actions. I will not be colonized, not by White people nor by anyone who forces any label on me. Not with any form of guilt (I spent enough years as a Catholic TYVM). My people still live in poverty and in special places set aside for them. Slavery has not ended. I know racism, I don’t need a primer or a racesplainin’.

Oh, yeah? Closed comments? That was a lesson I learned from a very wise person indeed. You call it silencing? I call it self-fucking-preservation from your fucking abuse. I won’t take any more of your public floggings, and is sure as hell won’t happen in my fucking space. Anyone who comes here will know the dog damned truth.

Where There is No Pain…

I am staring up at the sky, and I can see the clouds rolling by. I am going the other way. We are giving a nod to one another as we go our way.

The sounds above me are all muffled, of people going on with their lives. I put them out of my mind. They don’t mind me, and I certainly, at this moment, don’t care about them. The sounds around me are different. They are bubbled and thunderous but deadened. They don’t hurt like the stark sounds of being above.

I glide. Above, I ache, I hurt, I am slow. I can barely move forward. But here, I am a Titan. Gods wish they could move like me. This is where I want to be. My muscles move the way I want them to. They ache and scream with the movement, but there is support under every part of my body holding my limbs as I reach.

I turn face down now, tuck my head, and open my eyes. The world is clear, and the sun beams across the floor in ripples, because it isn’t even as strong as I am here. I expel my lungs as I stretch my legs, moving them like scissors, gently. Every gentle motion has so much power. The movements that bring me glances of pity above make me feel like Poseidon’s child here. I was made to use my body here.

I reach, grab, and pull, gently, and glide again. I turn my head (it doesn’t hurt!) and take in a desperate measure of air greedily. My torso turns as if it can just swivel freely. I look down below me, straightening my spine, and see the blue tiled “T” marking my distance. One. Two. Three, and a tuck, and my legs push me back the other way.

I want to stay here. I want to remain where there is no gravity to pull me against myself and bring the pain back. I dread later. I dread even ten minutes from now, because we all have to pay the piper…

The second lap is slower. I always start off too fast. It is always too long between these trips, or too long between seasons (it is never the same indoors). My body can move, but my lungs burn faster. I have to come up more.

Halfway through I have to stop.

My feet (they are tingling now…again) find the ground and my hands reach for the wall.

No. Please.

I fight on. Because I want to stay here.

Where it doesn’t hurt.

The sun beats down on me.

Reach. Grab. Pull.

And it isn’t just the water I grab for. It is time.

Tuck, push, kick.

Glide.

Under here I am alone with my thoughts, with how good it feels.

But my lungs ache for that air, and my body is tired, and my neck strains now when I turn for that air.

As I grasp that wall I am crying.

I need help out.

I am too tired to stand.

I have to rest.

And all I can think about is the next time I can get back in.

Trust Me

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A couple of weeks ago I asked my PCM for a referral to OB/GYN to replace the IUD that I had to surrender over the summer. She and The Guy and I have been talking for some time about the options and realities of having another child with my condition, and the answer we came up with is that we will wait for a little longer and see if I am still doing well with my current regimen.

Usually these things take weeks to schedule, but they called the next day, and I had my referral appointment on the second day. No matter what your history in the OB/GYN clinics you have to have counseling in order to get birth control through the MTF (all the ones in which I have been treated anyway), and the idea is that you get to talk to your OB/GYN about all of your birth control options, what you want from your birth control, take his or her advice, and decide on what is best for you. That is the theory, anyhow.

Some people (like me) have an idea ahead of time what they want or what is best for them. I, for example, due to my medical history and ongoing condition, am not able to use a hormonal birth control. Because of that I know that the copper IUD (ParaGuard) is the best option for me. Also because of this, I often read up on ParaGuard and IUD use in women, and try to keep abreast of any information regarding IUD usage, risks involved, etc. The IUD has such a bad reputation from so much misinformation that I feel the need to stay on top of this. Some would say this makes me a big smarty-pants-know-it-all. I say that sometimes a woman can’t trust that her doctor is going to take her word at face falue, and in the off chance that her doctor isn’t as awesome as mine she needs to be prepared. I am privileged to have information available at my fingertips.

I did not realize that my appointment would not be with my usual kick-ass OB/GYN, Dr. K, the same one who saved my fallopian tubes and life this summer and who promised to give me a shiny new IUD whenever I was ready for it. Not panicking when I saw the face of a woman I didn’t know I sat down as she introduced herself as Nurse Midwife V and told me that she had been looking over my file. Great. Maybe she was doing her background reading too, because I really tire of bringing every doctor up to speed constantly on my condition when it is right there on the computer screen for them to see. I don’t have a bunch of degrees and I can keep up with the required reading.

Before I had even the chance to say anything she told me that I was “not a candidate for an IUD” because of my ectopic pregnancy, and that she was not going to refer me for one. When I started to say that I understood that there were some risks she cut me off and told me that my pap was also past due and kept talking. I tried to assert myself past her obsession with people rooting around in my vagina, to let her know that I was aware that there were risks involved with the IUD, but that I knew that not only was what happened to me rare, but that I knew it was rare that it might happen again. But she wasn’t having any of that. She kept right on talking like I wasn’t even there.

I told her that my regular doctor had already said I was fine to have one. She responded by saying that it usually took weeks to get in to see him, as if this was supposed to deter me somehow. I also tried asking if the new ACOG regulations had been implemented yet, thinking this might distract her and get me closer to my goal (also, I am in the lag area none of them know what to do with, being 29, soon to be 30) and all she would say was that my pap was past due. Is it? I don’t know. I had a normal one in late 2008. I am in a mutually monogamous relationship…

When I left I told the front desk that I would no longer allow Nurse Midwife V to treat me. I am currently in the process of filing a formal complaint against her. What shouldn’t have happened here was having everyone from the desk staff to the NCOIC (that’s Non-commissioned officer in charge) tell me how nice Nurse Midwife V is and how everyone likes her so much, and that she is well known for being very good at what she does. That might well be true, great. My experience is that she was condescending and rude, and didn’t help me with my medical needs to my satisfaction. I think that people forget that sometimes, that doctors and nurses are also here to provide a service for us. I have a medical need, and she didn’t meet it. I shouldn’t have to settle for that. No matter how nice and great she is to work with. I also shouldn’t have my experience erased and dismissed by everyone in place to help me when things go wrong for me. That is not good patient advocacy.

I am rather privileged, however, in that I was able to make another appointment, and I saw Dr. K the next day. Had I been someone who had to drive a long way to a clinic, I might not have been able to. Had I had to pay out of pocket for this visit, or if my insurance limited the amount of OB/GYN visits or birth control counselings I was allowed per year, I would not have been able to. Had the travel cost me money I did not have, this would not have been possible. Had I not had the type of job I do where I set my own hours, I might have had to miss work. These are the kinds of things that women face when they come up against providers like Nurse Midwife V, providers who don’t want to listen to women, who won’t talk to women about their own bodies and medical histories. Providers who don’t trust women to be actively involved in their medical processes. Providers who can’t be bothered to involved women in the partnership that should be their own medical care, especially when it comes to their reproductive health. As it was, having to go back a second time was already taxing on my spoons, and stressful, because now I have be on my game. Suddenly I have to come in educated on something that my provider should have known the first time.

Thanks to meloukhia’s indominatable Google-fu I took in the information I was looking for, backing up what I had already said, that an ectopic pregnancy did not preclude me from having an IUD (or, that a previous ectopic pregnancy was not a contraindication for an IUD). Dr. K was impressed that I was so prepared. He told me that he had heard that information, but he himself had been so busy that he hadn’t had time to read any of the journals for himself. He told The Guy (who went with me this time, because they like to banter back and forth in Korean) that I should come in from time to time to keep him updated on current women’s health, and said he wished more people came to him so informed. He said that whomever told me that I couldn’t have an IUD was wrong. I was prepared, but I shouldn’t have had to come in as if I was fighting a war.

Two weeks later I have my IUD.

Nurse Midwife V didn’t care to ask why, after having one IUD failure (as rare as they are, b/c they are pretty much the most effective form of reversible birth control out there, with a fail rate of less than one percent), I would want another IUD. She didn’t bother to find out anything else in my medical history that might affect my decision to make that very personal choice about birth control, like that I am on medication that might have contraindications with hormonal birth control, or that previous specialists had determined that hormonal birth control is a migraine trigger for me. She simply asserted her own opinion (as wrong as it turned out to be) and called it a day. But all of that information is in my medical record if she cared to look. The same record she said she reviewed when she made her initial judgment.

And now, I can’t trust her.

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