All Change

August 15, 2014

“Oh for fuck’s sake, why can’t they design kitchen equipment that does what it’s supposed to do? This is FUCKING RIDICULOUS!”

Other family members looked on nervously as I flung things round the kitchen. The trigger event for this Gordon Ramsay style kitchen meltdown? While draining pasta, a few strands of spaghetti had slipped through the colander into the sink. I know, terrible isn’t it? I blame my hormones for the extreme reaction.

Until about two years ago I had only a vague notion of what the menopause entailed. I knew about the night sweats and hot flushes, but that was about it. Menopause is deemed to have happened when you have gone 12 months without a period. What I now know is that when you reach this milestone, all the drama is over. Perimenopause is where it’s really at. Perimenopause is the term for the fun-filled years leading up to the menopause, and it lasts on average for four or five years.  It’s been quite an adventure so far…….

It all started innocently enough with irregular but otherwise normal periods. This is grand, I thought to myself. Then last summer, the famous hot flushes and night sweats kicked in, but that stage didn’t last very long. Still grand. Though given the unpredictable nature of perimenopause, I suppose they might be back (great!). In the last 8 months or so I’ve experienced a range of other, more annoying symptoms.

Menopause brain

This my term for the brain fog, lack of concentration and mental confusion which can mark perimenopause and which at times has caused me to question my sanity. I’ve always been absent minded but this is on a whole new level. Stress exacerbates these symptoms hugely. During a recent family crisis I found myself making really stupid mistakes at work. I remember being horrified on seeing a cash reconciliation sheet which was clearly the work of an innumerate idiot, only to realise the idiot was me – I’d been handling payments that day.

Long hunts for the car in car parks are a regular occurrence, as I have nofainting lady recollection whatsoever of parking the thing. Worst of all was a two month long ‘reader’s block’ where I found myself incapable of concentrating enough to read a book. Tragic. I made my excuses at the book club.

Menopause narcolepsy

In the last few months I’ve learned that if I want to achieve anything after about 4pm on any given day, I need to keep away from soft furniture. If my ass lands on a sofa or bed, however briefly, I WILL fall asleep. Instantly and deeply. The fatique is extreme and overwhelming. There are also occasional spells of dizziness and lightheadness where, like a posh Victorian lady, I’ve had an attack of the vapours necessitating a little sit down because I feel weak. Smelling salts please!

Rivers of blood (You have been warned)

The periods have got heavier. And heavier. And longer. And more painful. The last one carried on for over three weeks for pity’s sake. Industrial strength sanitary protection is deployed, but fails to hold back the tide. As emergency back-up, tampons and towels are worn simultaneously, sometimes even two tampons at once. White trousers are not my friend. Underwear has been destroyed. I’m fairly aghast at this latest development and find myself equating all this blood loss with the very essence of youth draining away. Will I be a shrivelled old prune by the time it stops?

Anyway, last week I finally copped that there’s probably a cause and effect connection between the rivers of blood, the tiredness and the brain fog. I dragged myself off to the GP. Sure enough, blood tests showed that I’m anaemic so a course of iron and B12 injections should sort that out. As for the periods from hell? “You can’t put up with that” declared the doctor, making me want to kiss her (I didn’t). She’s packing me off to a gynaecologist to see what can be done to resolve matters.

Every woman will experience perimenopause differently of course. My own mother says that her periods just stopped in her 50s and she had no symptoms in the lead-up (my mother is what’s known as a trooper). I decided to write this blog post to share my experience as I’ve found that it’s still a fairly taboo subject here in prudish Ireland. Although I’ve recently discovered a website called “My Second Spring” which is a good outlet for women going through *adopts Les Dawson mother-in-law expression* ‘The Change’.

Anyone care to comment? Ah go on.

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Remembering Rory

November 3, 2011

There is a framed black and white photo hanging in my parents’ living room. It’s of me at my third birthday party, posed on the sunny garden wall while most of the other partygoers are playing in the background. Sitting beside me and holding my chubby hand in his, is my first playmate Rory. He was from just over the road, close to me in age and the eldest child in his family. Less than a year after the photo was taken, Rory died of leukaemia.

I only have snatched memories of Rory. I remember him calling to the door to see if I wanted to come out to play (it was the sixties, and our suburban cul de sac was a safe playground even for three and four year olds). I remember his little toy horse on wheels, which he called ‘Jossie’. Most of all I remember my mother gently explaining to me one day that Rory had gone to heaven. I cried and cried, though I must have had only a minimal understanding of death and its finality.

I’ve looked at that old photo many times over the years and wondered how my friend would have turned out had he survived. Rory’s parents somehow got through their unspeakable loss, have stayed together to this day and have raised two daughters. They still live on my old street and I often wonder how they coped with the devastation of losing their precious little boy, every parent’s worst dread.

Recently I ran into Rory’s mum Mary. She was very keen to know if I still remembered him. We began to talk about him, and for the first time I heard the story of the lead-up to his death. It was even more heartbreaking than I had imagined.

A few months beforehand, Rory had been admitted to hospital with complications following a bout of mumps. He recovered and was sent home but, to Mary, he was ‘never the same child’. She knew there was something wrong.

He was generally unwell and suffered repeated episodes of tonsillitis. She wore a path to the GP’s surgery to try to discover what was wrong, but time after time was dismissed as an over-anxious mother. The attitude she got was very much ‘there there dear, calm down it’s just tonsillitis’. But she knew.

Rory was given an appointment to see an ENT specialist, but it was months away. Eventually, in desperation, Mary took it upon herself to phone the consultant at home at the weekend. He wouldn’t hear a word of apology for calling him at home, and agreed to see Rory the following week. When Mary brought her son to the outpatient appointment, she also brought an overnight bag for him. Because she knew.

Sure enough, the consultant felt that there was something a lot more serious than tonsillitis going on, and admitted Rory immediately for tests. Mary says that leaving her son behind at the hospital that day was the hardest thing she has ever done.

When the results came through, her deepest fears were confirmed. Rory had leukaemia. It was at an advanced stage and he passed away just four days later. She told me that she still cries for her lost boy, more than forty years on. After she left, I cried too.

Before we parted, I asked Mary what her GP had said to her after Rory died. He apparently said he would always regret not listening to her and that in future he would pay much greater attention to mothers. Because they know.

Consumer champion and money-saving guru from the Irish Times, Conor Pope was a guest on George Hook’s Newstalk show the other week. The topic was the cost to middle class parents of bringing up a child.

Conor pointed out that before the child is even born, most middle class parents pay between €3500 and €7000 to secure the services of an obstetric consultant – private health insurance does not cover this cost. Apparently you need to get straight on the blower the moment you see the little blue line appear in the pregnancy test window if you want to get the obstetrician of your choice.

Now this topic is a bit of a personal bugbear of mine. Why are women with straightforward, healthy pregnancies attending obstetric consultants for routine antenatal care and normal deliveries? Do they really need to shell out thousands of euros to have a highly trained consultant tell them that their blood pressure is fine, the baby’s heartbeat and growth are normal and that their blood sugar levels are no cause for concern? That is a midwife’s job.

The Royal College of Obstetricians and Gynaecologists in the UK lists the following definitions on its website:

  • Obstetrics deals with problems that arise in maternity care, treating any complications of pregnancy and childbirth and any that arise after the birth.
  •  Obstetricians work alongside midwives, whose speciality is usually normal pregnancy and delivery.

 In other words, during a straightforward, healthy pregnancy and delivery, there is no need for a woman to see hide nor hair of an obstetrician.

My first child was born in London 11 years ago. Private health insurance is relatively uncommon in the UK and I, like the vast majority of women, relied on the NHS for my antenatal care. Most of my antenatal visits were to the midwives clinic at my local health centre, with a couple of GP visits in between. I usually saw a midwife called Mandy, a reassuring and warm Welsh woman.

Everyone is assigned a consultant obstetrician, but only sees him or her if problems arise during the pregnancy. Because I had a history of hip problems, I was referred once to the hospital so that the obstetrician could confirm I was capable of having a normal delivery.

On the day of delivery, I was delighted when Mandy arrived on shift towards the end of the labour, and welcomed my son into the world. There was no doctor in the room. A breezy registrar had appeared shortly beforehand to check in on us, announcing that “if baby hasn’t appeared in the next 10-15 minutes I’ll be back to ventouse”. That did the trick. Ten minutes later Mandy was handing us our first child and it was wonderful to be attended by someone I knew and trusted.

Back in Ireland a few years later and expecting my second child, it seemed I had committed a terrible middle class faux pas by failing to take out private health insurance. A lot of people’s first response to my news included the question “Who is your consultant?” They seemed almost embarrassed to hear that I had thrown myself at the mercy of the public system, and I was given grim warnings about the endless queues I would face at the ante-natal clinics.

They were right, the queues literally stretched up and down the length of the hospital corridors. However, I never had to join those queues. At the end of my initial booking visit I was offered, almost as an afterthought, the option to attend a midwives clinic, as I was in a low risk category. This was apparently not a very popular option as I wouldn’t be seeing a doctor for routine care, but I jumped at the chance. At every subsequent visit I walked past the seemingly unending lines of women waiting patiently for a doctor, till I reached the door marked ‘Midwives Clinic’. Here, I never waited more than 10 minutes to be seen and was soon on my way home, passing the same women still queuing on my way out.

That was in 2002. Since then, a handful of midwife-led clinics have opened and a few hospitals are offering ‘domino care’, where midwives visit mothers before and after the birth in their own homes. These services are still very limited however, and are only available to public patients.

This seems to send out a clear signal that midwife care is somehow a second-best option. Of course there are many reasons why women need to see an obstetrician during pregnancy and childbirth. Older mothers, multiple pregnancies, high blood pressure and many other risk factors  require specialist care. Many women probably feel that they are not prepared to take any chance with the wellbeing of their precious child, and they want the reassurance of a familiar face at the birth. But if they were offered the chance to be cared for by a small team of midwives in their local area, one of these midwives would be there for them on the day. And of course at the first sign of a problem at any stage during pregnancy or labour, the midwife can call in an obstetrician.

I don’t know how this system of over-dependence on obstetric consultants and under-valuing of midwives has arisen here in Ireland. It seems an awful shame, not to mention a waste of money. After all, for most women, pregnancy is not an illness. If and when we get the long promised universal health insurance, perhaps everyone will be offered high quality community midwife care, with obstetric consultants available for those who need them, regardless of ability to pay.

My Secret Shame

August 3, 2010

  • I have a secret. My secret is this.

About once a month, when nobody else is around, I get into my car and drive to a fairly grim retail park on the northside of Dublin. When I spot what I’m after, I pull up the car, roll down the window and speak to a teenager wearing a baseball cap. I hand over my money and am given a package. I drive off again, to a quiet spot in the car park. Only then do I open the package and get my hands on……a Big Mac Meal.

I love Big Macs. I love the cheap white bread of the soft sesame seed buns. I love the ‘secret sauce’. I love the melted plastic cheese. I even love the pickles.

But my McDonalds habit fills me with shame. I never discuss it with friends or family. I always use a drive-through (sorry, ‘thru’) rather than queue up at the counter with my tracksuit-wearing fellow customers. I park well away from other cars while eating the food, and always dispose of the packaging before I get home.

This shame has got nothing to do with problems around food or eating or an obsession with weight loss. Up to the age of about thirty, I was a skinny person. Since then, a combination of motherhood, encroaching middle age and reduced mobility (I need a hip replacement) has changed that. I have a definite muffin top and could do with losing about a stone, but that’s probably never going to happen. Diets are alien territory to me, I have limited will power and frankly, I just don’t care that much. Being quite tall, I tell myself I can carry a bit of extra weight.

Cooking is a pleasure, I love to eat well and can cook a mean Thai green curry from scratch. My weekly bag of organic, locally grown produce is delivered to the door, there are very few foods I don’t enjoy and I love visiting the occasional fine dining restaurant. But pizza, fish and chips and Chinese takeaways also form part of my diet and I have a weakness for tortilla chips and Mr Kipling’s French Fancies. However, I never feel guilty about eating any of it. Basically, I pretty much eat what I like.

So, how to explain the unique shame of the furtive McDonalds trips?

Could it be because I associate it with the most miserable experience of my working life, when I worked as a ‘crew member’ as a teenager? I still remember it vividly; the hyperactive, bossy managers, the smell of vinegar on my hands from the huge plastic buckets of pickles, the beeping of the machines instructing the drones when to flip the burgers. Most of all I remember the catchphrase ‘Time to lean, time to clean!’ (© McDonalds Corporation) being bellowed at me several times during every shift – I wasn’t the most motivated of crew members.

We were given free food if we worked a sufficiently long shift. The rumour among the crew members was that they put some addictive ingredient in the food. Did this get me hooked? I doubt it, except in the sense that the human body craves fat, salt and sugar.

I have read ‘Fast Food Nation’ by Eric Schlosser. I have seen Morgan Spurlock’s documentary ‘Supersize Me’. But my mortification predates these exposés of McDonalds and other fast food companies. I was embarrassed before I even learned the truth, but it wasn’t enough to put me off. My cloak and dagger trips even continued during the BSE scare.

If I have to pick a reason for my shame, it must come down to snobbery. Your stereotypical McDonalds customer is a young, working class mother giving her kids a treat, someone popping in for a milkshake on the way back from the methadone clinic, or a hoodie-wearing teenager attracted by the sheer cheapness of the food (€6.50 for the Big Mac meal!). In other words, not me.

My visits will no doubt continue, though now that I have posted to this blog, they are no longer a secret. I have finally outed myself. I’m lovin’ it.