A few weeks ago I wrote a letter to Lifeline about one of their Australian ads (you can read it here). They have now responded.
The email reads:
“Thank you for providing your feedback about the Lifeline HOPE billboards. I am so sorry that they have made you feel the way they do, this is certainly not our intention. We had aimed to provide a strong message of hope, which is the undercurrent of all our communication campaigns. To date, I have received plenty of positive feedback about this campaign, your feedback is the first negative, but it has weighed on me heavily. Thank you for taking the time.
The intention behind the poster was that people would see the ad and be encouraged to hold on with HOPE for whatever the reason may be that they need it. In doing so, I had hoped to encourage a more compassionate Australia. For those in chronic pain, I had hoped to impart hope in the continuing advancement in scientific discovery and the dedicated medical teams who are working in the field. The furthest thing from my intention is to cause anyone harm or to experience isolation.
Ella, this ad placement has been provided pro bono, so I am unable to change where it is placed or how often. I can give you the undertaking though that the next iteration of posters I am given the opportunity to post I will ensure there is a different hopeful message.
I am sorry for the distress this has caused you, I hope my response will give you some solace.
Ina is the National Manager of Communications and Public Affairs for Lifeline.
Whilst I still think the ad is deeply insensitive and demonstrates a lack of thought, and I don’t buy the “continuing advancement in scientific discovery” thing (anyone with a chronic illness knows that waiting for medical advances is about as hopeful as waiting for a tsunami in the Gobi Desert), I am gratified to have received a reply. I also very much appreciate the apology. I do hope that they bear the message in mind and give thought to those of us with chronic pain in future ad campaigns.
I strongly encourage anyone with the spoons to call out ableism or exclusion when they see it. People without intimate experience of disability or chronic pain don’t even think to double check on whether their language or actions are inclusive – goodness knows I rarely did prior to actually having endometriosis and working to educate myself. Every time we point it out is hopefully a time the other person goes away to think about it and takes the time to educate themselves and change their behaviour in future, and hopefully become an advocate for us as well.
It was June 2016 that I was first diagnosed with endometriosis. Since then I have learned a lot of things that I desperately wish I could go back and tell that young woman. If I could, these are some of the things I’d really want her to know. Some of them are personal to me, but most of them have fairly general applicability.
1) Don’t go to that doctor
I had no idea back then that there were different types of gynaecological specialities. I thought it was all much of a muchness. I was originally diagnosed and operated on by a fertility specialist. Whilst she knew about endometriosis, as any gynaecologist should, endometriosis was not her primary area. I don’t know if my increase in suffering after that operation was due to a lack of knowledge and skill on her part, her preference for surgery rather than attempting to manage the condition with medication first, or simply something that would have happened regardless of who I saw. Whichever, I wish I’d seen someone else, because when the problems arose, she was stumped and essentially told me she had no idea how to help me. Which leads me to…
2) Don’t have the surgery
I honestly thought I’d tried every medication I could to reduce my period pain and that surgery was the only option open to me now (an illusion that the abovementioned doctor did nothing to dispel). Whilst surgery is incredibly useful for many people, it was devastating for me and I wish I had been given other alternatives to at least try.
3) Find a doctor that you can trust
I don’t know if I could have done anything about this sooner than I did, because it took a while for me to realise each medical relationship wasn’t working, but I wish I had been with Dr Edi-Osagie from the start. I have yet to present a problem that he hasn’t been willing to try and beat or said something he hasn’t listened to. Previous doctors have either been stumped by my issues or decided that they’ve given me sufficient quality of life and I just need to be satisfied with that. I’m not, and neither is Dr Edi-Osagie. I trust him, and that’s a big deal.
4) Trust yourself more
Endometriosis is one of those diseases that plays tricks on your mind. There’s few visible symptoms, and people around you question and downplay your pain. This makes it very easy to doubt what you are feeling and convince yourself that you are wrong about the severity of your pain and the appropriateness of your reaction to it. The gaslighting effect is horrible and I think it causes delays in getting effective treatment. If I had had more trust in myself, I may not have had a better medical outcome, but I would have been a lot happier.
5) Be prepared for physical changes
I’ve been really struggling with body image (again) lately. Being in menopause has me putting on weight even though I’m exercising regularly and eating well (and yes, my caloric output exceeds my input by a decent margin). Between that and the swelling, I feel a bit like a pig, only without their body confidence and contentment. I wish I could brace my old self for those changes and revel in the body I had while I had it. Not just for looks, too – I’d take it for more runs just to feel the power in my legs, and lift more weights to experience that satisfying burn in my arms.
6) Do your research in the right places
Scouring WebMD for the clinical definition of endo doesn’t prepare you for what it is actually like. Even the list of symptoms is not exhaustive, and some website actually provide complete misinformation (the most common being that pregnancy or hysterectomy will cure you). The best source of information I have ever found is my local endo support group. I have learned so much from them and I should have joined and engaged the second I was diagnosed, checked if I was seeing the right doctor and being given accurate advice, and built connections with women who could help me.
7) Do better record-keeping
This is still something I could improve upon. Record-keeping on both a micro and macro level is really useful. By macro I mean having all your medical records collated and a timeline of major events (diagnoses, procedures, dates of starting and stopping medication). This makes it super easy for you and your doctors to review your history at a glance. By micro, I mean tracking your food, sleep, stress, exercise, mood and pain. This helps alert you to trends and triggers, which teaches you how to help yourself better by avoiding stuff that hurts and engaging in stuff that helps.
8) Understand that your life will change
The biggest thing I was unprepared for was how much I wouldn’t be able to do. I took it for granted that I could sit at a desk for hours at a time, walk 5km and then eat a garlicky meal with onions and beans. I took it for granted that I could shower at the end of a long day. Never did I think I’d become an occasional wheelchair user. I thought I’d be diagnosed, cured, and that was that. In fact…
9) Realise that a diagnosis is just the beginning
If you get a diagnosis and if that diagnosis is confirmed, that is not the beginning of the end. It is not as simple, sadly, as problem then solution. It is problem then several attempts at solutions and then many sub-problems, all requiring different solutions, some of which are in conflict with each other. It is not a simple journey, and while a diagnosis offers some hope, it is not a fait accompli from thereon out. I want to go back and seriously manage 25-year-old me’s expectations.
10) A diagnosis is not the end
I cried the day I was diagnosed. It is scary being told that you have a disease that you didn’t know was there, even if you expected it. It is even scarier realising that you have it for life. I cannot properly convey the enormity of that. It’s not the end, though. Life may be very, very different after a diagnosis, and it may well be harder, but you also learn a lot of things about love, true friendship, your own abilities and limits, and weird medical facts. You have to change your life in a hundred annoying ways, but it does become the new normal and you learn to live with the differences. Endo is chronic but not terminal. While there’s life, there’s hope.
What do you wish you could say to your younger, pre-diagnosis self? Would you do anything differently?
2018 was a challenging and scary year. I once again defied my doctor by seeking a second opinion on whether further surgery was going to help, and then going for it. I left the organisation I’d worked at for five years. I adopted a dog and a cat. I endured massive amounts of pain and dealt with debilitating medication-induced depression. I also learned some things.
1) The world forgets the sick and disabled
Not the most cheerful starter, I’ll admit. It’s true, though. Healthy people (and I’m sure I was guilty of this prior to really suffering from endo) are massively prone to making sweeping statements that reveal that they simply do not factor in the sick and disabled. For example, “everyone should be able to change a tyre.” “Saying things are too expensive is just an excuse.” “There’s no reason not to do this thing.” They speak from the perspective of a totally healthy person and totally forget that actually, disability and illness are perfectly valid reasons why people can’t do the things they are talking about. Whether they mean to or not, it is really exclusionary language and it leaves a lot of disabled people sitting there thinking, “What about me? Why don’t I factor in here at all?” It’s a really isolating feeling. It makes you think that the world does not care. We’re an after-thought at best.
2) Some people actively hate the sick and disabled
It’s an attitude I honestly thought had gone the way of the third Reich, but there are real life people existing today that think disabled people are a drain on society, contribute nothing, and therefore have forfeited any right to assistance, and, on occasion, existence. It was shocking and horrifying for me to learn and I’m a bit ashamed I didn’t understand it fully until last year.
3) Spoon theory is so applicable
I’ve previously written about spoon theory, and it honestly is such a useful way to describe how I navigate a day. I became particularly aware of it over Christmas. We went to stay with my husband’s family in Adelaide, and there were a lot of people there. I was tired from the drive (it’s at least 12 hours from where we live in the east), my pain levels were quite high, it was hot, and the noise and pressure to socialise just wore my spoons down before I’d really done anything at all. I felt terrible, because my in-laws were so generous and hospitable, and I ended up spending a good chunk of Christmas Day in bed because it was all I could cope with. I was spoonless. Without spoons. Physically, emotionally and intellectually completely drained.
4) You have to make the most of the good times
If I have a good day, I need to grab it with both hands and exploit it for all its worth. That’s the day I need to text my friends and ask if they are free after work. It’s the day I need to go for a run, clean the house, shop for groceries, walk the dog and cook for the week ahead. Those days are limited and precious and you never know when they will stop happening, so you have to carpe the heck out of that diem.
On the flip side, of course…
5) Life as a spoonie is a gigantic series of compromises and gambles
If I do too much on a good day, I risk guaranteeing that my next day will be bad. On the other hand, there’s no guarantee that it won’t be bad anyway, so maybe I should just go for it. On the other other hand, tomorrow I do have this thing I’m supposed to do so perhaps I should be extra careful.
It’s a similar story with medication. The mirena is jam-packed with wonderful progesterone that should dramatically slow the growth of my endometriosis. However, it now turns out that it could be responsible for a whole bunch of my pain. Meanwhile, my Zoladex definitely reduces my pain but menopause is not exactly a party, and adjusting to it is seriously rough.
6) A doctor you can work with is worth their weight in gold
I have seen four specialists since my initial diagnosis in 2016. The first one performed the surgery that sent my endo spiralling downhill. The second refused to believe that I could possibly have endo in me four months after my initial surgery and seemed like he didn’t believe my pain because he couldn’t provide a reason for it. The third was great for a while but it felt like, after the second surgery and sticking me full of progesterone devices, that he kind of lost interest and was a bit annoyed that I wanted more relief than I was experiencing. When I met Dr Edi-Osagie, I finally felt like I had found a doctor who listened and genuinely cared. The difference that makes is literally making me tear up just thinking about it. It matters so much.
7) Sometimes hard and scary decisions are necessary
Quitting my job was terrifying. Committing to a third surgery that would cost a lot of money was terrifying. Every time I take a new medication it is scary because I have such terrible trouble with side-effects. The decisions we have to make can alter our lives and our bodies, sometimes irrevocably, and there are so many to make. I’m scared every time, but I’ve got a lot better at taking the plunge because I know I have to.
8) Depression is harder than you can possibly explain
To someone who has never suffered that overwhelming apathy and bleakness it can sound silly, like something you should just be able to pull yourself out of with a little bit of gumption. You cannot. It’s like trying to sit up when a giant is stepping on your back. Even writing it out now I can’t actually convey what it feels like.
9) You cannot overstate the importance of support
I actually can’t imagine what my life would look like if I didn’t have my husband and my parents. Ok, I can, but I don’t want to, because I would be very poor, living in a pigsty if I hadn’t been evicted for not paying rent, not eating properly, and probably not having the strength to challenge my previous doctors when they started to give up on me. I certainly wouldn’t have the wonderful life I have now – and it is still a wonderful life, even if the tone of this blog post may be making people question how I feel about it.
10) You are stronger than you think
Novels and movies tend to romanticise suffering somewhat, and so you grow up thinking, “yeah, I’m tough, I could suffer.” Then you do, and you realise that actually suffering really sucks and you can’t do it after all…but then you can. Every day that you are still here is another day you’ve kept fighting. I re-read the phrase, “while there’s life, there’s hope” today, and honestly, I have never appreciated that quote so much. One day this particular illness may outstrip my capacity to live through it. I don’t think it will, but it could. But not today. There’s hope.
Did you discover anything new in 2018, either about you or about the world in general? Let me know in the comments.