MENOPAUSE WHAT?? Seriously??

That was the text my friend Bee sent me after I told her what I'd be doing this summer.

I went to my doctor expecting to talk about surgery, birth control, and/or pain management. Instead he suggested menopause. Temporarily. 

"Let's shut everything down for six months," he said. "See if that helps." 

While part of me was intrigued by the mental image of myself as a cyborg fembot who can shut down bits here and there at will, most of me was taken up with a silent internal scream of, "But I don't want to go through menopause!"

I'm 34!

I went to find a picture of a female robot (turn on SafeSearch first) so I could make a joke about Rosie never having to worry about menopause. Then I discovered that "sexy Rosie Hallowe'en costume" was a thing. So there's that.

After some adjustment and a serious cry at Bee's house, I've gotten more comfortable with the idea of the Summer of Menopause. I'll be taking monthly injections of Lupron Depot to suppress my estrogen levels. I had my first one on the 18th of July and will continue through till the 18th of December. I'm still worried about the changes my body will go through, but I'm keeping up a mantra of, "It's only 6 months and you'll feel much better after."

The idea is that without estrogen, all my endomees will starve and shrink away, and I'll be left symptom-free for at least a few years. When the endomees do start growing back, we'll be able to manage them more easily than now, when they're allovertheplace.

So far I haven't experienced any side effects from the shot, other than feeling wicked tired these last few days (but that might be because I'm extremely busy at the moment). But it's only been a week. It can apparently take 2-3 weeks before the first side effects from the shot materialize. Here's hoping that when they do come, they're a minor irritation on my way to feeling healthier all the time.

Angry Meatwad

Alright, so: medical definition of endometriosis. 

Endometrium is the lining of the uterus, the stuff women slough off during their periods. In endometriosis, that lining grows on the outside of the uterus instead of the inside. I know, it's crazy! In Stage I endo, a little bit of lining grows outside the uterus, being all badass and like "I'm not going to play by your rules, uterus. You don't control me!" The severity progresses along to Stage IV, where the lining grows all over the place, and you get lesions and adhesions (where the growths sort of glue organs and tissue together), and big endometrioma (cysts) that grow on the ovaries and wherever else they want.

One of the weird things about endometriosis is that the staging of the disease does not correlate to pain experienced. A woman with Stage I could have really horrible pain and bleeding all the time, whereas other women (like me) have Stage IV but not much pain. Until recently, I hardly had any pain at all, even with such severe endo and having one ovary taken out due to endometrioma (word of the day: ovary removal has the incredibly fun title of 'oophorectomy'!)

Dan Savage once wrote a column where he imagined tiny gnomes stomping on barrels of champagne grapes  as the origin of vaginal secretions. I've always liked that image. In the same way, I always imagine my endomees as puffy pink, vaguely hostile blobs, sort of like a Pepto-Bismol colored Meatwad.  

If you don't watch Aqua Teen Hunger Force, well, you should. Go watch it now.

Endo is unusually mysterious given that it affects an estimated 40-60% of women with painful periods. No one really knows why it happens or why some women have pain when others don't. There's no cure for endo, but it's not fatal either. So that's something.

Since I'm not worried about fertility, more treatment options are open to me. I'll talk about my current crazy treatment in my next post.

Quality of Life

When I had surgery a few years ago, my doctor told me I might have to make a choice between preserving my fertility and getting a clean bill of health. "I want to be well," I told him. In that moment I knew for certain that I was never going to have children.

My husband and I had always leaned strongly towards remaining childless, so this was not a major sacrifice for me. It was more like the final stamp on a package already wrapped and waiting to be mailed. The choice was made and done with.

That choice shifted my focus on my endo, though. For many women, endo is the barrier between them and motherhood (a struggle made all the crueler given that pregnancy often relieves the symptoms of endo, sometimes permanently). For me, the standard became "quality of life."

At first, I could tell myself I was lucky--endo didn't affect my quality of life. I didn't have to worry about surgery again, because my quality of life was good. If I wound up on the futon with a Magic Bag watching Nostalgia Critic one or two days a month, that was a small price to pay for my overall good quality of life.

Slowly, though, those one or two days a month became four or five days a month. I had to cancel plans more frequently. The question became, "What is quality of life?" Is three days of illness a month okay, but four too much? How many times do I have to postpone my plans before it becomes unacceptable? I was often in pain, but not a lot of pain, and I knew so many people "had it worse." I started trying to quantify my quality of life mathematically: on a scale of 1 to 10, with 1 being hardly any pain at all, four days at 5 is equivalent to two days at 7, and last month I had that 8 but it was only for a few hours...then again, a whole week of 3 is exhausting...

Last year I wound up in the emergency room after a week of on-again off-again pain and constipation. That day marked the beginning of the downward slide until, finally, I was forced to admit that "quality of life" is a myth. There's just life. My life was one that involved pain and isolation, and I decided it didn't matter how mild the pain was or how infrequent the isolation. It's my life and I want to live it the best I can.

So no more mental math. No more brushing aside the bad days. No more comparing my pain to other peoples' and deciding things aren't so bad. I'm not going to discount myself by discounting my reality. 

Abandoning "quality of life" doesn't mean wallowing, or dwelling on my problems endlessly (that's what this blog is for). It means that I'm no longer willing to accept less than the best for myself. Whatever needs doing to make my life the best it can be, I'll do it.

Endomees, you are going down.

Covert Ops

I was going to do this right. Write up a week's or a month's worth of posts, all carefully structured to communicate a single theme or topic, before firing up this blog. This first post would be dryly witty, a touch self-deprecating, and contain a medical definition of endometriosis ("the disease spellcheck doesn't recognize!") and some background on me. Ambee. Oh and also an explanation of the title.

That is, after all, the way the books and eHow sites tell you to do it. Pick a target audience. Refine your message. What does your target audience need to know and want to hear? What do you want to tell them?

Then today I wound up, once again, soaking in a hot bath despite the record temperatures this summer, popping Buscopan and cancelling important plans. I thought: I am so tired of my body being a battleground. I hate that it's my own self against me. My little endomees grow so crazily. So many of my finite resources go to trying to keep my own insides in check.

Maybe that's why I don't want to think about a target audience while I'm fighting my personal battle against endo. I'm sick of being in a war. A wee civil war, just one soldier, and a covert war at that. All the words surrounding endo are ones you generally don't use in public. I've developed polite code. My back hurts (I'm constipated). My tummy hurts (I have cramps). I don't feel well today (I'll be on the toilet for the next hour). Even the medical terminology surrounding endo--uterus, ovaries, menstruation, bowels, adhesions--is taboo. One can speak frankly about a broken leg or influenza, but try bringing up how your uterine lining grows on your bowels and makes it hard to poop. Watch everyone try to keep a straight face. It's easier to wage a secret, silent war on your own.

It's not fatal, but it's wearing.

If you're here, you either love me or have endomees yourself. If it's the former, I'll try to ignore you. Otherwise I'll start self-censoring out of guilt and embarrassment. If it's the latter, welcome. I hope my experiences will help arm you for your own covert ops.