A life long battle

The challenge to women suffering from endometriosis, extremely painful periods in the menstrual cycle, is not only enduring the harrowing experience that usually spans three to seven days or more monthly, but it is also that of surviving through a demanding work environment.

This aching menstrual condition puts a damper on almost all activities of those afflicted and in many instances results in social isolation, yet getting through the work situation is the most testing because many persons have no choice but to seek eight-hours a day, five days a week employment.

While medical science is still unsure of the cause of endometriosis, what is known is that it never goes away because any successful medication must be taken until menopause, and treatment bears risks for those of childbearing age who wish to have, or continue having children.

According to Consultant Obstetrician and Gynaecologist and British Fertility Society Certified Lecturer Specialist, Dr Damian Best, this ailment has to do with the uterus as for some reason tissue from this area gets deposited in other parts of the body ranging from womb, to bowel, to even the nose and serves as a monthly trigger for the excruciating pain.

Like other causes of painful periods, endometriosis affects women during their monthly cycle as the lining of the uterus, endometrium, thickens with the hormone oestrogen and matures with the other hormone progesterone in preparing a place for a fertilised egg to nestle for pregnancy.

He has said that the endometriosis complication comes because “that same tissue has taken up residence in these very awkward places” such as inside the uterus, in the ovary or the pelvis.

He added that through common research “you would hear that people have endometriosis in their belly buttons; in caesarean section scars; in their chests; in their nostrils.”

Explaining that because of the tissue’s positioning it “has nowhere to go.” He added, “So if it sticks around in there and it’s reacting to your hormones you know what it’s going to do when it does not have any place to go, it is going to wreak havoc. Your body is going to say it has a problem. It is going to react, it is going to invade. It’s going to become inflamed and painful. This thing is incurable. This thing is devastating,” said University of the West Indies Lecturer, Dr Best.

That explanation came during a recent instalment of the Barbados Drug Service lecture series on health at the Lloyd Erskine Sandiford Centre.

“I was diagnosed when I was about 16, but I had pain from early as well,” said Julie Howard, chairperson of that lecture forum. “This can sometimes send you crazy or feel like it’s sending you crazy.” Howard’s problem graduated from adolescent life to the world of work.

“I was about 17 in my first job … my pain is usually around three in the morning. It would wake me up.” She said that owing to the little knowledge about her true condition at that time family members thought it was a passing discomfort.

So, faced with the call of her first job, Howard related, “my mother said ‘you going to work’ because at this point we didn’t know what was wrong, the vomiting, the diarrhoea, the pain and everything else that goes with endometriosis.”

“I think the pain stopped around 6 a.m. My mother got me ready and packed me off to work. By the time I got to work I sat at my desk, I threw-up all over my desk and the boss packed me back home.”

“I started to have pain about the same time that I started my menstrual cycle,” said Dawn Williams, a member of a panel that led off a discussion following Dr Best’s lecture.

“It got worse as time went on. And it’s only when I was at university in the middle of a presentation for a law class, I felt dizzy and in a lot of pain,” she said, explaining that the discomfort led to her collapsing and having to be rushed to the university doctor. Williams’ condition was further complicated by the presence of ovarian cysts and fibroids.

“The cyst started probably about 2002,” and diagnosis of endometriosis came four years later. “In 2006, I was 23. I started having pain from age 12.” She has had four surgeries that took away the other two complaints but in testimony to the abiding nature of the main ailment, she said, “I still have endometriosis, and I still have pain.”

Dr Best said he audited 1,492 gynaecology notes taken from clinics in Barbados in 2014 and found that, “3.9 per cent of those patients being seen in gynaecology had endometriosis as a diagnosis.”

His findings, out of a female population of some 144,803 women as of the last census, are for those who attend clinic and are diagnosed.

But given the reluctance of woman to discuss this condition, even with the doctor, the likelihood is that there are thousands of persons like self-described ‘Endo-Warriors’ Julie Howard and Dawn Williams in the workplace quietly suffering and enduring.