December 7, 2005

For several months now my lower abdomen has been giving me considerable, and unprecedented, grief. This is something medical folks like to call chronic pelvic pain. And my cycle went from relatively regular to completely fucking haywire in the same span.

Here's a firsthand report on chronic pelvic pain: it sucks ass.

I've had several doctor visits, several more ER visits, run through two courses of antibiotics (to eliminate the possibility of pelvic inflammatory disease), had lots of blood work (and of course the requisite numerous pregnancy tests), an ultrasound and a CT scan -- all normal. In fact, the only even remotely hinky test result was an abnormal Pap smear. Cervical cancer is not usually painful, so this provided little explanation for my pain, but had me terrified nonetheless. Today I had a doctor appointment to discuss biopsy results and Make a Plan of Action.

The verdict: I'm still in pain, but to some extent, I'm officially out of the woods. This is to say: no infection and no cancer!

The cervical biopsy showed that the abnormal cells were only near the surface. That's commonplace, and puts to rest my fear that another type of cancer was causing the pain, and that it had just begun to spread to the cervix. We decided to follow up with another Pap test in four months to see what's up. All fairly standard and boring.

It feels very, very good to be medically boring.

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About the pain (which continues -- oh does it ever continue): my doc is thinking with no signs of cancer or infection, endometriosis is the most likely culprit. It seems to run in families, and in fact to become more common with each successive generation of women in a family. My mom had it. So it goes.

Doc said to continue to take the Pill -- skipping the placebo week -- and see if the condition improves. We agreed that it would be a good idea to do a laparoscopy to 1) get a definitive diagnosis and 2) remove any endometrial growths). He said he probably will not be able to perform one until February, and that his office would call me with a surgery date as soon as possible. This would be an outpatient surgery, not a hospital stay, which is good because 1) no hospital food and 2) I can schedule for time off work and assistance if I need it while I'm recovering. All of this is also good because 1) there seems to be more than one advantage to each positive point here and 2) I like making lists.

In the meantime, I told the doctor that I am interested in finding an acupuncturist or naturopath to help me out, as I have heard they can do wonders for managing this type of pain. He said that is fine with him as long as I let him know what they are doing. I've been doing some research and asking around and I have a couple of good names so far.

So, while still ouchy, I'm quite relieved that all the really Bad Stuff has been eliminated. I'm also quite grateful to have a doctor who is supportive of my efforts to seek complementary care, and to live in an area where it is so available, even to po' folks like myself. I am also enormously grateful to the army of family members, housemates and friends who have provided all kinds of support for me during this period. For the first time in a long time, I have confidence that we know what is going on, and that I am going to get better.

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The root word of "hysteria" is "the wandering womb." I haven't done a lot of firsthand research on this, but most of us have heard of this diagnosis: in a less enlightened age, doctors believed a woman's uterus could travel throughout her body, and that this explained a whole host of emotional and physical maladies specific to women. Hysterectomies, as I understand it, were all the damn rage then.

Now, when we tell people they are being hysterical, we're effectively saying, "It's all in your head."

Most women I know know from that. This is why I made myself the squeaky wheel. I was not about to fucking die, or lose my capacity to have children or my sex drive because some jackass in the ER thought this was All in My Head. I was determined to be a nuisance. I was determined not to be told it was all in my head, though I received a variety of equally dismissive answers in the course of my search for treatment.

The first -- "Sounds like the clap; have some penicillin, kiddo" -- was easily the most hurtful. The fact that I was put through a second round of antibiotics at the onset of the cold season after I'd tested negative for the pertinent STIs sucked also. And so did being told I was having an anxiety attack when I was going into shock and then being asked to leave as opposed to, say, being asked if I wanted to see a mental health worker. (Of course I probably would have said NO I JUST NEED TO BITCH ABOUT THIS ON THE INTERNET LEAVE ME ALONE YOU ASSHOLE QUACKS, but for fuck's sake.)

All of this sucked. And most women I know have comparable horror stories. I told a couple of friends I was just waiting to be diagnosed with literal and actual "hysteria," the wandering womb, and bled with leeches or given an unnecessary hysterectomy. (The perfect complement to any 25-year-old Single Gal's lifestyle: menopause!)

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Curiously, endometriosis is about as close to Wandering Womb as it's medically possible to get.

What happens is that, for little-understood reasons, the cells of the uterine lining start to proliferate and attach to areas that aren't the uterus. Usually they attack to other reproductive organs, like the ovaries or the fallopian tubes, but have been known to attach to really weird places, like the lungs. They still run on the same hormonal clock as endometrial cells inside the womb, however, and freak out when they find there's no mechanism in place (i.e. movements of the uterus) to slough them off once a month. Some women have endometrial growths all over the insides of their bodies, and show no symptoms. Some are found with one teeny tiny endometrial growth and report excruciating pain -- either with periods or persistently. In my case, my Cycle was (and is) so terribly haywire, and the pain so persistent, that it was difficult to say whether it was worse at any given point during the month.

Perhaps not surprisingly, this particular variation on Wandering Womb is often treated dismissively: take Midol, take Valium, it's stress, it's fatigue, it's all in your head. You're hysterical. Get plenty of fluids and go lay down.

It's kind of funny, actually, now that I've got my diagnosis and I know I'm going to be OK. A little less so when you consider the whole host of other female maladies that present with symptoms like the ones I had, when you consider that many, in the early stages, are treated with the same advice. And that in cases of advanced endometriosis, reproductive cancers or PID, women can be killed or castrated by that advice.

Obviously, I haven't closed the book on my treatment, but to the best of everybody's knowledge I have closed the book on the diagnostic process.

But I can't truly do that, and write about it in a public forum, without throwing in a little PSA.

Sure, it's important to get fluids, sleep, manage your emotional life, exercise and pop a couple of ibuprofen if the going gets tough on your cycle. But you know your body better than anyone. If something doesn't feel or seem normal to you, it probably isn't. Get it checked out. Be the squeaky fucking wheel.

Yeah, modern medicine is irritatingly bureaucratic, and it's easy to slip through the cracks. Don't. Lots of doctors and nurses (both male and female) are misogynist pricks who will tell you that you're crazy, will ask you tolerate the intolerable, to go home, load up on Valium and Vicodin, and leave them alone.

Don't let them. Be the asshole. Be the squeaky wheel. Be hysterical. Do it for me.

Patriotism is a much vaunted term in India. For a country that has endured for centuries, but took years to recover from what should have been a mere blip in its existence, the rule of the British, patriotism has sustained India through constant threat of disintegration due to religion, invasion, and internecine conflict. It is a quality that is imparted to one in childhood, with the same degree of intensity and dedication that is reserved for religious and moral education, reinforced by singing of the national anthem, the celebration of Republic Day and Independence Day as well as the knuckle biting and jubilation for cricket matches that keep the nation on the edge of its seat. Having spent most of my life in Calcutta, India, (or Kolkata as it's now known) I have absorbed that pride, that passion for a country that I wasn't even born in. Unlike common perceptions of patriotism, I would like to point out that this is not an unquestioning, blind feeling of attachment, but rather a fondness and a certain degree of tolerance for what India stands for, the idea of India.

I haven't been back for two and half years. During that time, my identity has undergone subtle remakings, I am now married (indeed, this sojourn is to celebrate a second instalment of the wedding), on the way to completing my PhD, and feel more at ease in my skin, a blessed advantage of growing older. I am more mature, less of a control freak, and have learned to enjoy life rather than stressing over its trajectory.

And India has changed too. Dispatches from my parents tell me of a Calcutta dotted with shopping malls and multiplexes, meccas to new wealth from increased globalisation and trade. The phenomenon of the call centre is now ubiquitous, churning out young hopeful Indians speaking with an accent (and oddly, possesssing names) more redolent of the American midwest than the Deccan plateau. They harbour dreams of upward mobility, having a car, and a life out of a glossy magazine, or nearer home, like those portrayed in Bollywood movies, that invariably depict either the very very rich, or the very very poor.

And this, I fear, is not my India. What charmed me about India, after spending considerable amounts of time in first world countries, was its reality, its originality. Its lack of homogeneity. Its unapologetic unabashedness for being what it was, who it was. But now, with the steady march of globalisation, I'm not sure how it feels. The urban centres, from what I can gather are becoming more and more anonymous, both in personality as well as appearance. Patriotism itself has become commodified, an emotional vein that advertisers can tap into, to sell anything from tyres to washing detergent.

I am British; my passport says so. But I feel Indian, and always have. Patriotism is unfashionable in the west; it seems almost not to exist in Britain, except either in a right-wing, extremist way. If I were to find that the India I believe defines me no longer exists, then I will feel, for the first time in my life, in a very real way, homeless. I'm hoping that this won't be the case.

Gold hit a 24-year high today, rising against all major currencies and all major commodities. Diversification by second and third tier central banks, who find themselves burdened with US dollar reserves, out of currencies like the US dollar and the euro has caused the price of gold to skyrocket.

The gold price hit a record of $873 an ounce in January 1980, and hit $502 for one day in December 1987. Since then it has recovered from lows of about $250 an ounce in 2001 and has surged almost 15% this year alone.

I finally got a job today! Last week I went to the city of Greenville, and filled out an application at the local K Mart. I called them about three or four days later, asking if they had looked at my app yet. They told me that they had been quite busy at the time, and that if the boss man needed anyone, that he would call. "This is not gonna come through", I thought to myself. But today at about 10:00 AM, K Mart called and told me to come in tomorrow for orientation.