We Should Share TMI

This post is inspired by a recent personal health situation - one that I couldn't have possibly navigated if some important people in my life had not been open to discussing information normally considered "TMI" (too much information).  

In short, two weeks ago I had a hysterectomy. 

How did I get there?  Well, it all started in January.  My doctor had been advising me that I would soon 'age out' of the combined birth control pill (i.e. the one that contains estrogen), and in January she advised it was time to switch to an IUD or a progestin-only birth control pill.  As I wasn't keen to have something installed into my cervix, I opted for the funded* pill.  My doctor advised that many women have had breakthrough bleeding on the funded pill, but to give it a go for three months. At the time I also complained of frequent urination, but not in a way that led me to believe I had a UTI.  She tested me for one anyway, and it was negative.  There was no follow-up. 

I effectively had three months of non-stop periods.  My breasts were an entire size larger as well - which often happened the week before my period on the combined pill, but this was ridiculous. I tracked all of my symptoms in a spreadsheet (because of course I did).  After three months, I went back to my doctor and asked for the progestin-only pill that wasn't funded.  It would set me back $50+ for three months, but there was a far higher chance of less bleeding.  And I did have success for nearly 2 months - very short periods, my other symptoms were far less severe. I had done it! 

The other change I made at that time was hiring a health coach to help me lose weight. I knew what I needed to do around food and exercise, but not exactly how to do it. The program was going well - I was eating better (and more!) than I'd ever had, lifting weights again, and dropping the weight.

Until I hit a plateau.

Now, here's some TMI for you...it was because I hadn't pooped in a few days. My coach asked if it was normal for me, and you know, it wasn't. Just about that time, a good friend of mine told me she was scheduled for a hysterectomy. What?! I've been wanting one for ages - I had no use for my uterus - even considered signing up to a live donation program.  Anyway, she told me she had fibroids and finally had the explanation for her terrible periods.  I had no idea what fibroids were, so I looked up the symptoms: abdominal pain, frequent urination, breakthrough bleeding, back pain and...constipation. Fibroids are very common, especially in women my age and even moreso for women who have never had children.

I had all of those symptoms, but also had an explanation for nearly all of them.  Back pain? I'm 48 - of course I have back pain.  Abdominal pain and breakthrough bleeding? Well, that's probably due to the new pill and/or peri-menopause, right? Ultimately it was the constipation that I couldn't explain.  I pretty much only drank water, and heaps of it. Plenty of fibre in my diet too.  When my period went on for 2 weeks on the new pill,  I was off to see my doctor again to request a scan.

My doctor is a general practitioner and does not seem knowledgable in women's health, despite being a woman and my exact same age.  She hesitated when I asked for a scan (which would be at my cost), saying she doubted a fibroid could be large enough to cause constipation. I just kept asking until she referred me for a scan. In the meantime, we agreed to continue the non-funded pill until I had some answers about what my body might be up to.

I had a scan about a week later, with results the next day.  And here's where my amazing friends come in again, because my doctor provided very little information about the results. My doctor only emailed to say that I had multiple fibroids and that I should consider a hysterectomy. 

Trust me, you don't want to see an actual picture of this.

Fortunately, a friend of mine is a Sonographer! I sent over my report, and she decoded it for me: my uterus is tipped backwards, I had six fibroids, all tamarillo-sized and my uterus was about double the average size.  Where do I go from here?

Well, back to my friend who had just had her hysterectomy.  She and her partner had done all the groundwork in choosing an ob/gyn, and had had such a positive experience, they recommended him to me.  She also guided me through what to expect at my first appointment with him, and what to expect from surgery and post-op. 

And my coach! She also had had experience with fibroids, and knew how to change my diet and workouts to accommodate. I met my goal of 10kg weight loss with her help, which led to a better result during my surgery as well.

I knew what was normal for my body, and I still explained away most of my symptoms. If I hadn't insisted on a scan, how long would it have taken for my (soon to be former) doctor to order one?  

Throughout all of this, I never felt lost or confused because my friends were so willing to talk and share vital information, and I can't thank them enough:

- Suzanne for sharing TMI about her own health situation and guiding me through the entire process.

- RJ (Suzanne's partner) for sharing how he supported Suzanne and providing guidance to Darren.

- Sarah for decoding my scan report. She was also ready to scan me herself if I had waited any longer for an appointment.

- Anastasia for guiding me through and helping me meet my weight loss goal.

Share that TMI - you just never know who may need to hear it.

*Because New Zealand has socialised medicine, certain prescriptions are funded, which means they only cost $5. In this case, I could get 3 months of birth control for one copay of $5. 

Level One is Not Level None

So, what is it like now?

I have started this post so many times (and had it completely written last weekend before Blogger ate it somehow. Argh!) And now we are one year into this pandemic!

The approach New Zealand has taken is quite different from the countries where Covid is raging - mostly due to our very strict lockdown last year, which lasted 5 weeks, as well as our strict border controls. However, it is also different to some Asian countries who also stomped out the virus quickly and without shutting their borders. 

Our government decided to take swift and decisive action nearly a year ago, implementing a Level system. The details of the Levels have altered slightly to be more flexible over the past several months, but generally have stayed the same.  New Zealand was in Level 4 - the strictest level - for five weeks and then moved down the levels slowly until we reached the almost-normal Level 1 last June.  Since then, the majority of Covid cases in New Zealand have been in the quarantine hotels at the border. A few cases have jumped the border into the community and were met with either swift testing/tracing and/or an increase in the Level for a short period of time.

As our Health Director Dr. Bloomfield has reminded us, Level 1 is not Level None.  There are still some restrictions in place, and masks are now mandatory on almost all forms of transport. Beyond that, there are still hints that not all is 'normal' and that society in general is ready to transition to a higher Level if required: grocery stores have kept their plexiglass barriers in place, most stores still have indicators on the ground for proper physical distancing, and the QR Tracing system signs are everywhere - even on the bus!  Doctors and dentists have remained vigilant despite the drop in levels, as they are most at risk of coming into contact with someone who is unwell.

When levels do change, stores immediately post signs showing how many people are allowed in the store at a time, gyms send out emails reminding members of the rules for that particular level, and the government sends out the loudest text message alert I have ever received.

Because we are in such a good position, though, any new community case is a BIG DEAL. The government springs into action with interviews of those infected to figure out where they may have contracted the disease, and where they may have gone in public during the infectious period. Tracers aim to contact and test 85% of close contacts within 24 hours. Testing not only works to figure out the epidemiological link (i.e. how did it pass from person to person), but also maps the genome. This informs the response - is the genome new? Connected to a particular case at the border quarantine? What is the variant? Unlike cases in the US and Europe, we aim to figure out where every case originated. We even test the wastewater on a weekly basis to determine if Covid is in the community undetected.

This is great, right? Is it? Or do we know too much about how the virus is spread? In the latest cluster, the media released a fairly detailed diagram of the families involved and how the virus spread between them.  In one case, one mother caught it from another during an (outdoor!) walk.

Having this information gives me a sense of panic when I see that some states in the US are opening indoor dining and theme parks, eschewing the use of masks and distancing, and even opening schools. We may not always pinpoint how the virus jumps the border, but we do know how it has transmitted between people. This is our 'normal' and will be for months to come.

 

Our Country Bubble

 A while ago, I wrote a post about what it felt like to live in a country where the virus isn't raging, to live normally on an island surrounded by a world on fire.  At the time it felt off-putting, like suddenly coming into a bunch of money or fame that wasn't earned.  

And then the virus reappeared.

We still aren't quite sure how it made it into the country.  Our government has been quite transparent about all of our Covid cases - where they came from, how cases are linked both epidemiologically and genomically, what areas are at risk, and what they are doing to try to find answers.  They also communicate how to stay calm and be prepared, that there will always be new cases as long as it is out of control elsewhere in the world.  This communication has taken away the overall feeling (for me) that the virus could be lurking anywhere at any time.  

The resurgence was our largest cluster, largely because of the community it affected (Pacific Islanders, who generally are more social) and partly because some in that cluster decided not to believe the science and made some poor choices.  The government acted swiftly and stepped up the Levels throughout the country and the area affected. Once the perimeters of the cluster were under control, and cases reduced, the Levels stepped back down and here we are again living nearly normally.  

Sadly, three men connected to this cluster died. Our country mourned each death, reflecting on the life of each man. Did they have underlying conditions? Maybe, but that isn't reported here anymore because it's not important.   Reporting on "underlying conditions" only serves as a dog whistle to those who feel that the virus isn't that dangerous, or that they wouldn't have a severe case if they were to be infected. It takes away from the fact these men would not have died otherwise.

Since that large cluster, there has been another small cluster related to a port worker who likely caught the virus on a ship he had worked on.  This cluster was also caught early and swiftly dealt with - the minute the port worker felt ill, he left work, got a test, and isolated.  The cluster is small and seemingly already under control, so we all just carry on as if life is normal.

It's not quite, though.  I wear a mask in any crowded area, especially on transport. Recently, I traveled up to Auckland (the location of both resurgences) for work and made sure to wear my mask on the plane. Very few others did, though. The streets, shopping malls, and even the line for airport security in Auckland were *packed*.  It felt very dystopian (and a little nervewracking)  to be in crowds like that. 

We are lucky. But now it feels more than that - it feels earned. Not to the point of invincibility, but definitely the same feeling as being in a new job for over 6 months and finally understanding what is going on.  More cases will come.  Of course they will.  But I'd like to think we can adapt and respond as necessary. 

We voted! Twice! (Legally)

Every now and then, the New Zealand elections will fall in the same year as a Federal US election, and 2020 was one of those years.  In the space of a week, we voted twice - in NZ and by absentee ballot for the US election.

The elections are run so very differently, and it is such an interesting contrast to me.  While the US reelection campaign starts at least 1 year (sometimes 2 years) out from the election, the NZ one is only a few weeks.  Of course, the different parties here start fluffing their feathers out as soon as the election date is announced (by the PM - they pick the date, which is always a Saturday, in the third year of their term). This year had the added complication of Covid-19 - due to a resurgence in the community, the election was delayed by 1 month.  

Early voting here began 2 weeks before the election date, and it appears voters had already made up their minds and were keen to vote. Over 1 million votes were cast before election day (approximately 45% of the vote). Campaigning must end by midnight the night before election day; billboards must be pulled down, and all ads, including on social media, must stop.  I feel this is a bit outdated considering how many vote early.

And the voting itself? Easy.  Every registered voter received an "EasyVote" card in the mail, which we just needed to take to a polling place.  Any polling place - and there were heaps of them, with clear signage.  

Darren and I only waited about 5 minutes on the first day of early voting at the location we chose in Wellington city.  We signed in to the location with the Covid Tracer app, 'washed' our hands with sanitizer, received a pen to mark the ballot with, then received the ballot.  The poll worker makes several checks to ensure the person presenting the card is the correct person, then handed me the ballot for my area (Wellington City), as well as the two referendums we were voting on.  A few minutes in the booth and done!  

The Electoral Commission lays it all out so simply in both English and Maori: https://www.vote.nz/voting/2020-general-election/how-to-vote/

The polls closed at 7pm on election day, and we had preliminary results from the early voting by 7:15, with the final* result announced around 11pm.  The actual final election results (which include special votes) will be announced on November 6th.  The referendum results will also be announced that day.

I will note that we were very happy with the results and have high hopes for the next three years.

Now.  The US election...

It was not quite as easy.  Every state is different, and Maryland makes it medium-difficult to vote from abroad.  I first had to contact them to request the paperwork to request an absentee ballot.  The request was confirmed, at which point I then had to complete paperwork to request the actual ballot via email.  After a couple more weeks, the ballot was received.  I could have dropped off my ballot to the US Embassy or Consulate, but I didn't receive it in time.  Instead, I mailed it via international courier at the cost of $51!  Compared to those standing in line for 12 hours? Pretty low cost.

As of this writing, I have received notification from NZ Post that my envelope was delivered.  Maryland, however, has not yet acknowledged that my ballot was received or counted.  I'll update if/when that happens.

The election itself has me on edge, and I have scheduled to take some time off of work in case I need to deal with unpleasant feelings after election day. Let's hope I can save my vacation time for a more pleasant reason...

An Over-Abundance of Freedom

*mic tap tap* Hello? Anyone there? Is this thing on? *mic tap tap*

So, eh...it's been 4 years since we've written anything on this blog.  There are heaps of drafts that were never published, and may never be.  Today I want to share some thoughts about the state of the world and how we are carrying on in New Zealand...


I was in a yoga class last night. 

Wait.

That sentence would not have been remarkable 6 months ago. A year ago. We all know why it's nearly a 'brag' now. New Zealand has done remarkably well (*so far!) at containing the Covid-19 disease. Back in late March, we shut everything down and the government asked people to isolate. And we did because our Prime Minister told us we were a team of 5 million. Fortunately, we could easily close our borders and we didn't have an overwhelming number of cases in the community. We were out of intense lockdown in just 6 weeks, and into Level 1 by early June.

It's been 78 days since we've had a case from an unknown/community transfer.  

Technically we are still in "Level 1", but we live freely.  We can go to work, and school, and congregate at parties, concerts, sports events, bars and restaurants. We can use transport and shop and get our hair cut - all without masks. We can hug our friends and have morning teas at work.

And we can exercise in groups. 

As I moved through the poses in my 90 minute (restorative) class, I realised why I've been uncomfortable with this freedom over the past few weeks: I feel that I have an over-abundance of something that I cannot give away. 

This particular thought struck me because the owner of the studio holds the restorative class once a month, and only asks for a koha* payment.  When asked, she simply states "you can pay with anything you have an over-abundance of".  Such a great idea! And over the years I have figured out where to take certain items that I have too many of - extra containers go to the Free Store, extra clothes go to Dress for Success. Curtains? Sustainability Trust. We even have charities that 'rescue' food every day and redistribute it to food banks.

And here we are living freely, without any power to help friends and family overseas.

Here's my last point: after all the years living in the US with the "freedom" propaganda message shoved down my throat daily, only now do I understand what freedom really feels like.  And it didn't come in a moment when I was alone and doing whatever I wanted - it's arrived in the moments where I was out at a crowded pub with friends, or wandering through town on crowded sidewalks and yes, in yoga class.  Freedom exists when everyone can enjoy it.  We have an over-abundance of it here, and I wish I could share it...


*Koha: a Maori word frequently used in New Zealand meaning gift, present, offering, donation or contribution.