AVERIL ROBERTSON

I want to talk about pain. Chronic pain, in particular. And even more specifically, chronic pain that only comes from being female. 

When I was about ten weeks’ pregnant with my daughter, who is now 12, I started having severe pain in my lower back. My hamstrings were pulled tight – I used to be able to more than touch my toes and I couldn’t even bend to dry my legs after a shower. I still recall the embarrassment that came from having to call my husband into the bathroom to dry me, after he heard strange thrashing sounds – me ineffectually whipping at my legs with a towel – and asked if I was okay. I wasn’t even showing yet, except for the explosion in breast size; no one but us and our GP knew I was pregnant.

The shared care doctor, a fantastic GP I felt lucky to be assigned to, recommended seeing a physio. I managed to get a woman who recognised what was going on. The solution? To give birth. I saw the physio every week for pain management until I was due, even overdue (someone was two weeks late!). 

Here’s an important detail that, from that moment, set me apart from many women with pain associated with pregnancy. I’m severely allergic to NSAIDs. Like, anaphylactic allergic. I can’t touch aspirin or ibuprofen. I can’t take Voltaren (or even touch the gel). I can’t take Nurofen or Naprogesic. It’s paracetamol, or hard-hitters such as codeine and tramadol for me.

During the remainder of my pregnancy, I spent a lot of the time sleeping on an air mattress until we bought an expensive new mattress that helped. I had to have help with putting on shoes and socks. I couldn’t walk very far, or very fast. I hurt sitting down, standing up, and lying down. Imagine my joy when a random hospital midwife told me I needed to exercise more; at that point I could barely walk.

During childbirth, I honestly thought the problematic area of my back – the sacroiliac joints – was going to pop, even with an epidural. The pressure and pain – I don’t even have words for. 

After nine years of on and off pain, of needing to occasionally see a physio, to often do the wildly inelegant stretches I was given to manage the pain, and to explain to colleagues why I was standing weirdly as I talked to them at their desks, I broke in the first year of COVID lockdown. The pain became a constant in my life, and the pain could not be eased by stretches. I pretended I was fine. I went for walks, and when lockdowns eased I went for long hikes. The pain got worse and worse. 

Eventually, my amazing physio said it was beyond just her and referred to a pain specialist. The cortisol injections helped immensely, but my back pain continued to return every time I got close to my period. The pain specialist prescribed a natural medicine called PEA, but at over $120 a script, it was hard to justify the cost of taking three pills a day, every day, to manage five or six days of pain. The key? To take the PEA for the week before my period and the week of my period. It worked for a few months. It was amazing. 

My body disagreed. Why not go irregular, after 30 years of regularity? My period went from standard and predictable to wildly erratic. Two weeks, five weeks, and anything in between. I couldn’t predict it, which meant I didn’t know when I needed to start taking the amazing PEA to counter the period pain, which would trigger my back. 

Over several months, I devolved into a world of endless pain, not just during menstruation but during ovulation as well. Now, every movement requires me to consider how much it will hurt. Yes I could go for a walk, but when I later sit down, the movement from standing to sitting is excruciating. At a certain point, staying as still as possible is the safest option. No surprising movements. No risks.

What does it feel like? Anything from a deep-set ache low in my abdomen, to burning pain across my buttocks and into my hips. Sometimes it feels like a brand-new E string on a violin has been attached from my lower back all the way down to the backs of my knees. Sometimes it comes in contraction-like waves – if you’ve been in labour before, it’s those first few hours when you’re really close to asking for an epidural but not quite yet. It’s a feeling of abdominal fullness, of heaviness, that you feel certain must at some point become a long wee, a huge poo or a raucous fart – except none of those things are what needs to happen, or would even help. 

Here’s what else it’s like: worrying that it will hurt every time I go to stand up or sit down, and also knowing that it definitely will. Worrying it will be bad when I am with people I don’t really know. Worrying that I will have to stand on the train. Waking up and for a brief moment thinking, hey it doesn’t hurt, then when I stand up and get in the shower, it hurts within minutes. Waking up in the night so I can brace to turn over.

Here’s the thing. I love to hike. I love to bake. Currently, I can’t risk going hiking or even going for a thirty-minute walk because I don’t know that I can complete the path without pain. Baking requires standing and yes I can do that, but the cost is pain. I went to a friend’s funeral recently and stood chatting to an old acquaintance afterwards. When I went to sit in my car to drive home, I had to moan in pain to complete the action of sitting down. When I got home, I had to abandon what I had planned to cook and hand over to my husband. I love to cook. 

If I go into the office, I have to entertain the idea that I will need to stand on the train. Even if I score a seat, I have to brace at every possible opportunity that the train will change tracks: lateral movement really hurts. Once in the office, if I get talking to someone, I have to stand, especially if it’s a social thing. The alternative? Asking to sit down, when there is no visible disability that might require me to do so. Then I feel the need to explain. It’s exhausting.

So here I am, a visibly healthy 42-year-old who cannot stand, sit or walk comfortably for any length of time without there being a cost. Yes, I have a team of specialists trying to help. But that is not the point. I am extremely fortunate to have the funds to pay for these people to collectively mull over my dysfunctional body. What bothers me, beyond the prospect of a physically limited lifestyle for the rest of my life, is how many women are suffering from similar pain because we’re told it’s normal in pregnancy, in post-pregnancy, in middle age (hello perimenopause and menopause) and beyond (osteoporosis is coming for us all). Even worse, and even when we are told it’s not normal, the majority of us will not be able to afford the team of specialists required to work through the symptoms and resolve them. The costs are astronomical: a week or more of minimum-wage pay for a single consultation.

So, as I try to push through, I am grateful that I have specialists looking after me. As I pretend to be fine standing through a long event because I am young and vital, I am grateful that a doctor has given me a script for codeine that I can take, even if the pharmacist looks at me with questioning eyes: Does she have a drug problem? And as I pretend that the pelvic pain is not that bad, because women aren’t meant to comment on how debilitating it can actually be, I am grateful to have a female manager who understands when I put in sick leave for ‘female stuff’. I almost never do that, but I could.

Dealing with and treating pain is a class issue – only the privileged can afford the time to see doctors and the money to pay them. If you’re forced to go through the public system, you will likely be waiting many months if not years for attention. Because it’s not that bad, right? It’s just a bit of “mild discomfort”, “women’s problems”. 

So today I welcome the election promise from the current government to better fund long-term contraceptives (I tried it at my own cost because it might have made my period pain go away; reader, it did not) as well as better-funded support for women with pelvic pain and suffering the symptoms of perimenopause and menopause. It should have come years ago but at least it is being talked about. I can’t wait to hear questions about where the equivalent funding for “men’s health” is.

But mostly, I can’t wait to go for a really long walk and have the only consequence be inner peace.