Tag Archives: health

Fearmongering about painkillers – codeine

TW Discussion of suicide

So  I’ll preface this post with the following – I am not someone who uses codeine frequently.  I don’t suffer from any form of chronic pain, and apart from when recovering from surgery, will probably have medication containing codeine about once every 4 – 6 months.

I am passionate about people being able to access the medication they need, when they need it, without unnecessary hurdles being put in their way, and today’s news about codeine moving to only be available in Australia by prescription, is a hurdle in everyone’s way.  From me and my very occasional use, to those who have chronic pain who use it much more frequently.

Also, all the reporting on the topic is frequently terrible, conflating all opioid related deaths with those caused by codeine, and attributing carrier drug deaths and injuries (usually paracetamol or ibuprofin) with codeine.

Let’s start with some important numbers:

  • Population of Australia (end June 2016) a bit over 24,000,000 (source)
  • Victorian Road Toll (2015): 257 (source)
  • Number of women killed by intimate partner violence: Approximately 1 per week (around 52 per year on average) (source)
  • Number of deaths in Australia in 2015: 159,052 (source)

The importance of all these numbers will make sense further down this post.

I’ll start with the ABC article (the second that I read on this today) which claims in part:

“Medication that are available over the counter or through pharmacies should be substantially safe and not subject to abuse.”

Now paracetamol and ibuprofen are safe, generally in the quantities that the box tells you to take them.  Excessive paracetamol (overdosing) causes:

Signs of paracetamol overdose include drowsiness, coma, seizures, abdominal pain, nausea and vomiting. Another name for paracetamol is acetaminophen (often known by its brand name, Panadol®).

There is only a small difference between the maximum daily dose of paracetamol and an overdose, which can cause liver damage. Large amounts of paracetamol are very dangerous, but the effects often don’t show until about two to three days after taking the tablets. (source)

Excessive ibuprofen (overdosing) causes:

An ibuprofen overdose can damage your stomach or intestines (source)

Both of these drugs, which are commonly available in Australia, you can buy them almost everywhere (convenience stores, supermarkets, chemists, petrol stations, etc) are only just safe in the recommended doses.  If you have a compromised liver, or mix up your dosage, you can cause serious damage to yourself, if not die from the medication.

Neither paracetamol or ibuprofen are addictive however, so apparently it doesn’t matter how dangerous they are.

Back to the ABC article.

The TGA said misuse of over-the-counter codeine products contributes to severe health outcomes, including “including liver damage, stomach ulceration, respiratory depression and death”.

Overdosing on codeine causes:

Overdose symptoms may include slow breathing and heart rate, severe drowsiness, muscle weakness, cold and clammy skin, pinpoint pupils, and fainting. (source)

So the TGA is partly lying.  The liver damage and stomach ulceration are the result of the carrier drug, either paracetamol or ibuprofen.  I’m not sure how many tablets you’d have to take to get the overdosing effective of codeine from the blended paracetamol/ibuprofen and codeine tablets, but I’m pretty sure that the internal bleeding and liver failure will probably kill you before the “respiratory depression” does.

From the ABC:

Dr Greenaway said an Australian study using coronial data showed there had been over 1,400 deaths in a little over a decade.

A little over a decade.  Let’s say that’s 13 years since no one has bothered giving us the actual numbers.  That’s around 108 deaths per year attributed, apparently, to codeine.  Because the ABC (and all the other media outlets) didn’t bother to find the actual source of these figures, I’ve just spent 2 minutes finding them for you.

From a press release from the National Drug and Alcohol Research Centre:

The rate of codeine-related deaths in Australia more than doubled between 2000 and 2009, driven primarily by an increase in accidental overdoses, according to new research by the National Drug and Alcohol Research Centre at UNSW.

“While we can’t look at trends over time beyond 2009, our sample of 1,437 codeine-related deaths between 2000 and 2013 allows valuable insights into the circumstances surrounding these deaths,” said Ms Roxburgh.

Of the 1437 deaths included in the study, just under half (48.8%) were attributed to accidental overdose, and a third (34.7%) to intentional self-harm.

Most codeine-related deaths (1201 = 83.7%) during 2000–2013 were attributed to multiple drug toxicity. A small proportion (113 = 7.8%) were specifically attributed to codeine toxicity. The remaining 123 deaths (8.5%) were attributed to other underlying causes, such as coronary heart disease, cardiovascular conditions, or other drug toxicity.

More than half (53.6%) of the cases of codeine-related death included a history of mental health problems, 36.1% a history of substance use problems (including misuse and dependence), 35.8% a history of chronic pain, 16.3% a history of injecting drug use, and 2.7% a history of cancer.

Those who had intentionally overdosed were more likely to be older, female and have a history of mental health problems; those who had accidentally overdosed were more likely to have a history of substance use problems, chronic pain and injecting drug use.

Ms Roxburgh said these characteristics highlight a complex patient population in need of specialist services.

Ok, so the TGA is being even more dishonest.  123 deaths over a 13 year period were related specifically to codeine toxicity.  That’s 9.4 deaths per year.  The 1201 deaths were multiple drug toxicity, which would most likely mean, since it isn’t spelt out, that the individuals died from consuming multiple substances, such as paracetamol and/or ibuprofen containing codeine, and potentially other medication.  As I’ve already noted, overdosing on paracetamol and ibuprofen is very bad for you.

34.7% of those deaths were suicide.  That’s not people getting addicted to codeine and then dying, that’s people using a commonly available drug and committing suicide.  I’m sure that those who were intentionally self harming with drugs containing codeine would find any other drug that would have the same outcome, and yet I don’t hear the TGA calling for prescriptions only for ibuprofen and paracetamol.

I included the last bit of the press release because it’s a point I want to come back to.  Mostly that addiction is treated like a moral failing and not a social failing.

And moving onto the Guardian:

The use of common, opioid-based painkillers such as codeine, morphine and oxycodone has increased by four times over the past decade and Australian is among a handful of countries consuming the bulk of the world’s opioid medication supply, according to figures from the independent body responsible for implementing the United Nations international drug control conventions, the International Narcotics Control Board, published in the Lancet.

This is deliberately misleading.  You cannot get morphine or oxycodone over the counter at a pharmacy.  Including these two opioids in a discussion about codeine is muddying the waters.  Also, Australia “is among a handful of countries”.  What does that even mean?  What is a handful of countries, who are the other countries, and given we produce a lot of our own opioids, what relevance does this have?

The Guardian continues:

The Australian Medical Association has said it accepts the plan will result in additional health system costs and higher workloads for GPs, but AMA vice-president Stephen Parnis said that should be weighed up against the cost of harm inflicted by the misuse of codeine, intentional or otherwise.

The TGA is making a currently available, over the counter, widely used and not widely abused drug, into a prescription only drug in an environment where the current Australian government is attempting to reduce the number of subsidised doctor’s visits to everyone (source), which will make life even more difficult for those with chronic pain conditions.

The Guardian continues:

“We also know that the number of people suffering avoidable harm in this area has been increasing over time, to the point where, at least in Victoria, the number of deaths from overdose of prescription narcotics is higher than the road toll.”

And my numbers come into play.  The road toll for Victoria in 2015 was 257.  The number of people who die (on average according to the National Drug and Alcohol Research Centre) is about 110 per year.

Ah… but see what AMA actually said, “the number of deaths from overdose of prescription narcotics”.  This decision is about over the counter codeine.  It is not about prescription opioids of any other kind, and yet in attempting to justify a decision which is really just going to annoy and make life harder for people, we get all these other reasons.

The AMA dude has one more thing to say in the Guardian article:

Parnis said codeine also posed a hidden danger.

“The body converts it to morphine and in fact a proportion of the population can convert it so quickly that they can suffer serious harm as a result.”

This is true, but moving to a prescription based service is not necessarily going to root this out.  Are doctors going to get more training and time to treat addiction?  Are doctors going to know which person amongst the hundreds of their patients has a metabolism that can quickly convert codeine to morphine and potentially harm themselves as a result?  It’s very unlikely.

Moving onto the article in The Age:

A TGA statement released on Tuesday morning said there was evidence that misuse of codeine contributes to liver damage; stomach ulceration and perforations; low blood potassium levels; respiratory depression and death.

The TGA’s statement, again, is incorrect.  Misuse of paracetamol and ibuprofen contributes to liver damage, stomach ulceration and perforations, and low blood potassium levels.  The TGA is conflating two different sets of harm caused by different drugs, into one in order to bolster their position.

The Age continues:

The decision comes after reports of codeine addicts swallowing up to 100 tablets a day, and people “pharmacist shopping” to get around rules introduced in 2010 that restrict purchases of more than five days’ supply of the drug at one time.

“reports of codeine addicts”, citation needed.  Also, any more than 6 (ibuprofen) or 8 (paracetamol) tablets, yet alone 100 tablets a day is an overdose amount of paracetamol or ibuprofen.  I call bullshit on this claim.

Also, it’s not hard to “pharmacy shop”, almost everyone has to do it at one point.  Some pharmacists treat anyone who asks for certain types of medication as drug-seeking,, whether it be something containing codeine or pseudoephedrine (the one that works versus phenylephrine which doesn’t), or something else.  If a pharmacist treats you badly, you go to another pharmacy (if you can).

Despite the fact that pseudoephedrine can be used to make cheap, bathtub, biker speed (Tripod quote), you don’t have to get a prescription to get it.  Sales of products containing pseudoephedrine plummeted when manufacturers substituted in an ineffective ingredient (claiming it was helpful even though studies said it wasn’t), and pharmacists started treating customers who – legally – sought to buy the stuff that does work as though they were drug-seeking addicts. The same could be done to codeine really.

Back to The Age:

In 2013, Monash University researchers reported nine deaths over a decade linked to toxicity from codeine-ibuprofen medicines such as Nurofen Plus.

Less than one death a year from codeine and ibuprofen.  More women are killed in intimate partner violence per year and sadly the Government is doing sweet fuck all about that.  More people die on our roads each year, and the Government does quite a bit about that.  Also I don’t know whose figures to believe.  I’m not sure if this 9 deaths are just in Victoria, or are from a different type of study as undertaken by National Drug and Alcohol Research Centre.

The Age:

Government agency data also shows the number of Australians being treated for codeine addiction more than tripled over the decade to 2012-13, from 318 to more than 1000 a year.

More than 1000 a year.  That’s 0.0004% of Australia’s population.  Apparently that number (the 1000) is probably under reported as some people treat themselves for codeine addiction.  There isn’t any discussion as to how much codeine addiction costs the health system, so it’s hard to know if more than 1000 people being addicted to codeine, who want to not be addicted any longer, is a huge cost to the medical system or just an inconvenience.

This is in error.  Loads of resources and articles say that emergency hospitalisation of someone overdosing on codeine compounds cost about $10,000 each.  The AMA says “A review of 99 hospitalisations caused by the misuse of OTC analgesics containing codeine found they cost, on average, $10,000 per admission.”  That’s broken down a bit more over here where we find out that most of it is once again ibuprofen’s fault.

28 tablets per day?  That’s a lot.

When you treat addiction as a moral failing, despite the fact that most of the people who use codeine regularly are people who have chronic pain conditions, then you let everyone down.  The next person who becomes addicted to codeine after surgery or a bad fall is listed as the failure, instead of just something that sometimes happens when you’ve sustained certain injuries, have certain medical conditions, or have gone through major surgery.

The National Drug and Alcohol Research Centre at UNSW commented that:

Those who had intentionally overdosed were more likely to be older, female and have a history of mental health problems; those who had accidentally overdosed were more likely to have a history of substance use problems, chronic pain and injecting drug use.

Ms Roxburgh said these characteristics highlight a complex patient population in need of specialist services.

Instead of treating the underlying conditions that people, who use codeine regularly, have, we treat them like they are the problem.  Instead of treating addiction as an illness, we treat it as a moral failing.  We fail everyone when we act this way, and the TGA needs to actually consider the messages they’re giving those who use codeine regularly, and to stop misleading the public about the actual harm of codeine.

Related Posts:

Welcome to the 101st Down Under Feminists’ Carnival

Welcome to the 101st Down Under Feminists’ Carnival.  My apologies for it being late, I was trapped behind two epic assignments that I had to complete for uni.  They are now done, and I am free for the remainder of the year.  Woohoo!

Below is a collection of feminist writing from Australia and New Zealand, written in September.  If you want to host a Down Under Feminist Carnival, you can go here and let Chally know.  It’s not a lot of work, many people will send you blog posts to include, and it’s lots of fun.

On with the show!

Feminism

Liz wrote at No Award, “The invisible women“:

It’s one of those frustrating reads because Liz went in wanting to agree with everything it said, and wound up picking it all apart. Three over-long Facebook comments later, Liz remembered we have a blog.

Anna at Hoyden About Town wrote, “BFTP Friday Hoyden: Emma Goldman“:

At a time when the Australian government is doing its best to behave like a blend of Dickensian villains and French aristocrats, without the compensatory good taste in cravats of either [ed to note: this observation does not require updating], we are more than due for a genuine revolutionary for a Friday Hoyden. Emma Goldman was a Russian (or technically Russian Empire, from an area now in Lithuania) Jewish immigrant to the USA, who spent her life being persecuted for her work campaigning for the rights of workers and marginalised groups of all kinds.

Cesca at myflatpacklife wrote, “Stuck in the middle“:

I have turned into Mummy Pig.

Dammit.

Mummy Pig just wants wholesome family fun. She just wants some fruit. And five minutes to pick berries without having to stop and admire a four year old’s basically empty bucket, or be yelled at. She just wants jam and maybe a crumble or two. Why does she have to be judged for her food choices? Why does she have to have her dignity stripped away by a blackberry bush – let’s all come laugh at the fat pig stuck in the prickly thorns! Why does she have to involve the whole family and share when all she wants is a fucking dessert? It’s not all about you Peppa!

Celeste at Rantings of an Aboriginal Feminist writes, “The Politics of Miscarriage“:

Which brings me back to miscarriage. As stated, in the moment, I felt relief. I didn’t tell work at the time because I was on leave, but as the rest of my saga became apparent, I was left with no choice but to tell them. I required post-operative sick leave after all. Perhaps I felt relief due to my circumstances, but considering that these circumstances were in the confines of a heterosexual relationship, and considering that this relationship had gone the way whereby I ended up a victim of violence, how is this narrative not valid in the discussion of miscarriage?

Daisy Dumas and Anna Maxted at Essential Baby write, “Why working women keep quiet about miscarriage“:

“Nobody understands it unless they have had one. It is impossible to compute unless you have been through it, just like any grief,” she says.

She is one of a low estimate of about 150,000 Australian women who miscarry each year – the vast majority of whom keep their anguish to themselves and, if working, continue as usual through the ordeal.

Olive Brown wrote at The Wireless, “Please, call me wahine“:

I remember learning about Suffrage Day at school, but I don’t remember ever seeing or hearing about wāhine Māori in the narratives and representations I was taught. Wāhine Māori were very much part of the suffrage movement.  In May 1893, Meri Te Tai Mangakāhia, addressed the lower house of the Te Kotahitanga Parliament (Māori Parliament) – being the first recorded woman to do so – she not only requested wāhine Māori be given the vote, but went further than the contemporary aim of the European suffrage movement, and asked they also be able to sit in the Māori parliament. She was one of other influential wāhine also part of the suffrage movement.

Jessica Tuhua guest posts at Sacraparental, “Nine-year-old Jessica tells us about feminism“:

I wrote about feminism because not many people at my school know anything about it, and I wanted to use the opportunity to speak about something important. It was very difficult to write about, so I re-wrote my speech six times! 

Cristy Clark wrote at Overland, “Dissenting feminisms: reflections on the Feminist Writers Festival“:

In the lead up to the event, we were accused of programming predominantly white women rather than women from a diverse range of backgrounds. In fact, over 40 per cent of our speakers were women of colour, and of the remaining women, a majority were able to speak from a diverse range of perspectives, such as identifying as LGBTQI women, or as women with a disability – but we could still have done better in this regard.

Andie Fox at ABC Radio National (audio segment) with, “In Defence of Sexting“.

Reviews of things

Liz at No Award wrote, “Liz reads: 4 Australian novels“:

How amazing is fiction? People just MAKE UP STORIES, which I then buy and read and insert these ideas from other people’s heads into my brain!

Body political

Fat Heffalump wrote, “Melbourne Fashion Week Plus – The Political“:

I had a lot of really intense feelings about being invited as a special guest to MFW+, mostly for two pivotal reasons.  Firstly because I’m not a fashion blogger in any stretch of the imagination – I love clothes, and expressing myself through the way I dress.  I love colour and texture and shape and I love the way putting an outfit on can make me feel.  But my focus as a fat activist is changing the way that fat people are both perceived and treated.  Don’t get me wrong, I believe clothing and fashion are important in fat politics – after all, access to suitable clothing is important to be part of society and because fashion and clothing can be really empowering, especially to those of us who have been denied access.  But to be invited and supported by MWF+ as an activist to be part of the event, knowing that they wanted my very political, feminist, fat active perspective to be included in the event means a lot to me.

Tangerina writes, “Bodies, food and fitness in the workplace“:

When you have an open conversation about being worried you’ll put on weight if you have another piece of that brownie, you probably don’t stop to think how that affects the people in the office who weigh more than you. That the subtext of what you’re saying is I’m afraid my body will look more like yours. And that although most of you would be horrified to think you’re hurting people by making idle small-talk, you are making your workplace less safe for fat people, people with (or recovering from) eating disorders and people with different abilities and health needs than you. And that’s not okay.

LGBTIQ+

Chrys at Gladly the Crossed Eyed Bear wrote, “The Race to Irrelevancy – Shelton’s Australian Christian Lobby“:

Despite the millions of dollars the Australian Christian Lobby has ploughed into demonising the LGBTIQ community, it has decisively lost the battle for Australian hearts and minds. As the debate has progressed, the Australian public has moved inexorably towards treating their fellow citizens as equal human beings. The fear-mongering fanaticism of Lyle Shelton’s fundamentalist lobby group (which wants the government to spend $200 million to amplify its message of homophobic hatred) has failed to gain traction.

Rebecca Shaw writes at SBS, “For f*ck’s sake, stop treating the LGBTQI community like a political football“:

Wow, what a roller coaster we’ve all been on in the past little while. A roller coaster where you have to be ‘this LGBTQI’ to ride. A roller coaster called The Marriage Equality Debate that is mostly unpleasant and throws you around and makes you wonder if you will even survive. Even if you don’t want to be riding the roller coaster, even if you couldn’t give a shit about it, you are pretty much forced to ride it just by virtue of living your life in this country.

Rebecca Shaw continues with her ranty pants at SBS, “Straight people need to stop telling us how to feel about the plebiscite“:

Lots of things have made me angry about this whole plebiscite situation. There’s the homophobic arguments we have to hear, the fact our government won’t simply legalise equal marriage even though the mechanism is available and it is what a majority of the country wants, the fact that it is even an option that the rights of a minority might be literally put to a vote, and of course the fact that McFlurrys at McDonalds are no longer flurried, only stirred.

I wrote, “Being out makes a difference“:

Being an out bisexual is so a part of my life, I forget that it helps other people.  Two people, one a friend of a friend, and one a business associate, have commented positively on the article, one talked to me about bisexuality and the invisibility she feels because she is married to a man, as well as how she feels unwelcome in LGBTI spaces because she is bisexual and married to a man.  The other thanked me for the work I do (outside my paid work), saying that this was so important, and made such a big difference to people.

I also wrote, “A weekend of erasure”:

The main stream media (MSM) is not very good at discussing bisexuality.  They tend towards the old myth of “straight, gay or lying”, which means that for the most part people who don’t identify as straight, gay or lesbian, tend to end up with one of those labels anyway, because bisexuality isn’t an option, despite it being right there in the middle of the acronym for the community of non-straight and/or non-gender conforming people – LGBTI.

Families

Emily writes at Mama Said, “Four“:

“Even if the boy is four does he keep his mama?”

“Yes”

“Even if the boy is..” he struggled to free his fingers to hold up six or maybe eight – finally ten. “…this many?”

“Yes. Go to sleep”

Emily writes at Mama Said, “Goodbye, old friend“:

When I felt lost and hopeless trying to find my place in the world he was my companion. I felt as if I always had this funny little friend who would accept me.

At Tea and Oranges, “Transitioning to parenthood“:

And parents too, we’re all experiencing a lot of the same stuff! Snapping at our partners about little things, etc. Feeling torn between wanting to connect with the kids and wanting space away from them. I thought it would be handy to have one of those guides for us. Based on zero research because when would I get time to do that, just my reckons, so please add in the comments if you’ve got thoughts. These are all things that I’ve experienced at one stage or another, and all things that I feel much much more strongly when I’m at home fulltime.

Race, racism, representation

Nadia at Mixed Nuts writes, “Border Dwellers and Forked Tongues“:

Anzaldúa speaks of how being multilingual in a monolingual, monocultural, straight white world means that those of us who are aware of our multiplicity – the minoritised, the disenfranchised, the exoticised – are required to perform daily acts of mutilation on ourselves to simply exist. She talks of the silences that this forces upon us. She talks of the toll that twisting and silencing herself has taken on her spirit, on her humanity. And she resists.

Yassmin Abdel-Magied at Medium writes, “I walked out of the Brisbane Writers Festival Keynote Address. This is why.“:

There is a fascinating philosophical argument here. Instead, however, that core question was used as a straw man. Shriver’s real targets were cultural appropriation, identity politics and political correctness. It was a monologue about the right to exploit the stories of “others”, simply because it is useful for one’s story.

Yen-Rong at Inexorablist wrote, “Dangerous Ideas”:

She took aim at those criticising a white, British writer for penning a novel from the perspective of a young Nigerian girl. She poked fun at those who ask that others not speak or write on their behalf. She defended the right for writers to offend. She blatantly rejected the notion of identity. And she did so under the guise of expressing dangerous ideas.

Karen Wyld writes, “Media Decolonised“:

Similar to other colonised nations, Australian media is white. And, let’s not mince words, it shamelessly displays ignorance, cultural bias and racism. I don’t see this changing anytime soon. Not when there’s support for such outdated views – and a profit to be made.

Dr Sophie Loy-Wilson writes at the ABC, “Search for Daisy Kwok uncovers Shanghai’s lost history of Chinese-Australians“:

If the White Australia Policy has an afterlife, I came face-to-face with it in 1996. Flicking through Tess Johnston’s book, A Last Look: Western Architecture in Old Shanghai, I saw an image of Daisy Kwok outside her family’s now decrepit mansion in the Jingnan district of Shanghai.

Trinity at Fruit From The Vine writes, “10 things I wish my friends knew about being Māori“:

Please pause on this one. Ngai Māori, like a lot of indigenous cultures, have had our land, language and culture all stripped ruthlessly close to the bone. You may say, ‘Yeah yeah, stop playing the victim card, I know all this’, but the truth is, you don’t. If you’re not Māori, you may know the words, but you haven’t walked every step of your existence with this reality hanging over your identity. More likely to be words forming a sentence of a past-time with no personal connection to you, this is for Māori, our life, our pain, and the culmination of all our suffering summed up within a sentence.

Omar Sakr writes at The Vocal, “We Need To Talk About Lionel Shriver“:

The question is not, for example, can a white person write an indigenous person’s story? The question is, should a white person publish a story from an indigenous person’s perspective in a country that is still invested in killing and displacing indigenous people, in a country still overwhelmingly producing white stories in film, literature, and TV? Is it ethical for a white person to use their access, to profit from a story using experiences not their own, but which the market is hungry for because homogeneity is mind-numbingly boring but not boring enough to disrupt the inherent biases built into our society?

Language

Stephanie at No Award writes, “steph speaks singlish“:

Steph is in Singapore and using Singlish like a pro! (It’s easy, cos it’s like Manglish only a bit more different) Because most of our readers are Aussies, and if there’s one thing Aussies love it’s slang, she’s compiled a list of important words she knows/has been learning to use in Singapore.

Nadia at Mixed Nuts writes, “Diverse Women Writers“:

Some of this was discussed during the open forum, when the audience was asked to comment on the day’s proceedings and make suggestions for improvements. Overall there seemed to be a feeling that events like this one were useful because of how isolating it often is to be the only non-white, nonbinary, non-male, non-straight person in the room. To be with a cohort with whom we could share multiple intersecting parts of our identities was a relief. There was a discussion of the use of the word ‘women’ when what was meant was more broadly ‘not men’, and the possibility of using ‘women and nonbinary’ as an identifier was floated, which several of the people I spoke to seemed to think would work.

Monica Dux at The Age wrote, “Families that stay together sometimes shouldn’t“:

Writing about the term “community”, the celebrated sociologist Zygmunt Bauman observed that, while most words have meaning, some also have a “feel”. According to Bauman, “community” is such a word. It gives us a warm, fuzzy feeling. And the word “family” is very similar.

Politics

Jane Caro at The Big Smoke wrote, “John Howard’s comments: lack of foresight, lack of understanding“:

A few days ago at the National Press Club, ex-Australian PM, John Howard, claimed that it was just the “truth” that women would never achieve 50% representation in our parliaments (or anywhere else, I imagine) because of their caring roles. Well, Mr Howard, there is one area where women are rapidly approaching 50% representation and that is among the ranks of the homeless. It is estimated by those who work in the sector that 44% of the homeless are women. The fastest growing group without a roof over their head, in fact, are women over 55.

Chally wrote at Zero At The Bone, “Telling truth, but not the reality“:

Telling half the story has inevitably led to confusion and a split response. Responses to this comment seem to be split between “good on him for telling the truth” and “he’s had his day”. There are of course also the people who seem to think that Mr Howard was saying that women belong in the home and agree with him that that’s a good thing – which he probably meant on some level, given how concerned he was about people thinking he said a terrible thing, but didn’t say.

Jane Gilmore writes at The Feed, SBS, “Comment: Hanson’s policies on family law equally dangerous“:

Phil Coorey reported in July this year that the Nationals are considering giving support to some of the One Nation policies in an attempt to prevent rural votes leaking down to Hanson. He quoted one Nationals MP as saying family law was something the Nationals need to “treat seriously”.

If you believe the Nationals think treating family law seriously means added protection for abused children and women, please get in touch so I can tell you about this wonderful bridge I have for sale.

Violence in all its forms (Trigger warnings for most of these posts)

Clementine Ford wrote at Daily Life, “Rape culture is caring more about protecting an offender’s future than his victim’s“.

Sam Conner at Gimpled writes, “We’re Not Funded To Do That“.

Related Posts:

A weekend of erasure

Trigger warning for biphobia and bi erasure

The main stream media (MSM) is not very good at discussing bisexuality.  They tend towards the old myth of “straight, gay or lying”, which means that for the most part people who don’t identify as straight, gay or lesbian, tend to end up with one of those labels anyway, because bisexuality isn’t an option, despite it being right there in the middle of the acronym for the community of non-straight and/or non-gender conforming people – LGBTI.

So it started with a garbage fire of an article published by The Telegraph.  It’s a UK paper, I really don’t know how it rates generally, but this article was awful.  The article was titled: ‘I felt like I was falling’: the moment I found out my husband was leading a double life. He was gay 

Let’s take the first moment of epic fail in this article, by the author Camilla Smith:

My husband Peter was away for work when I found the postcard of Manly Beach, in Australia. Sent from an unfamiliar friend, there was a comment about watching men sunbathing, and how Peter would enjoy the view.

After 10 years together, seven of marriage, it was instantly clear that Peter was gay.

“Instantly clear” that despite what I assume were 10 years of mostly happy relationship, one where they were together for such a long time, that Peter is gay.  Not bisexual.  In fact, in this entire article, Smith is of the opinion that bisexual men do not exist.  She goes to great lengths to pain Peter a philandering gay man using her as a “beard”.

So Smith continues:

I had a cup of tea, walked the dog, and when Peter came home, I told him what I had found.

He didn’t break down. He didn’t try to deny the friend or that he had a sexual interest in men. He didn’t, however, agree he was gay.

I think, for the age group of men like Peter and Keith Vaz, the image of a gay man is different to what you see now. If you grew up in the 70s, being gay meant Larry Grayson and John Inman, camp-as-a-row-of-tents clichés. They must have looked at these images and thought, that’s not me.

It was such a narrow view of homosexuality. Now you have rugby players, CEOs and soldiers who are out, but not then.

And yet Smith has no clue about bisexuality.  For her, if a man is attracted to men, he cannot be attracted to women.  Smith’s view of the spectrum of human sexuality is so incredibly narrow, that she could not even conceive that her husband, the man she’s spent 10 years in a relationship with, could be bisexual.

I don’t think he wanted to come out because I don’t think he wanted to be gay. Somehow, for him, it was preferable to be bisexual.

Probably because he’s actually bisexual.  It’s this erasure that harms bisexual people so much.  Not just Peter who is in the midst of being erased by his wife, but every other bisexual who reads this awful story and feels that they can’t be bisexual because we’re not real, that they have to deny who they are because the only options are straight or gay.  This erasure leads to the incredibly high rate of domestic violence against bisexual people, as well as higher rates of suicide and drug abuse than gay and lesbian people.

I was happy to believe him. We had a good life, a nice home. I wanted to save our marriage. We went to counselling. We made love.

But every so often I’d have a snoop. And I’d find a ticket to a gay club, or find a receipt for a gay sex toy.

She wanted to believe him, but clearly didn’t trust him.  I don’t actually quite understand what Smith believed.  Clearly her husband was (and presumably still is) attracted to women as well as men.  You know, the definition of bisexuality is attraction to more than one gender, so Peter is doing a great job of that.

Smith’s lack of trust is incredibly grating.  She clearly isn’t interested in communicating honestly with Peter, talking to him about establishing boundaries that make her feel safe, talking about what he does.  No, instead she’s “snooping” through his stuff.  Finding a ticket to a gay club, which might just be where he was hanging out with his non-straight friends, or finding receipts for “gay sex toys”.  I have no idea what gay sex toys actually are.  I assume Smith found receipts for buttplugs or other anal play toys – and if he’s using them himself for his own pleasure, I don’t actually understand what her problem is.

I’m trying to put a time line together of this whole relationship mess, and Smith is not very helpful with that… but anyway

I do feel he stole my adult life away. He could have told me before we got married that he felt he was bisexual and wanted an open marriage. He could have told me when I found the postcard that he was gay and given me the chance to start again. He could have told me that like many men – gay or straight – he didn’t want to be monogamous.

Ok… no one steals your life.  Smith gave her time and energy to this relationship and apart from the time at the end when she was an untrusting, biphobic jerk, she seemed to be happy.  Probably apart from the IVF bit, no one likes that.

Maybe, and Smith doesn’t consider this, Peter didn’t know that he was bisexual when they married each other.  Not everyone realises when they hit sexual maturity that they aren’t the societally expected heterosexual.  People do come out late in life.  Also, nowhere in this whole article does Smith say that Peter actually admitted that he cheated on her.  She believes that he has, and I’m sure she would have included it if that conversation occurred and he’d put his hand up and said yes.  So perhaps Peter, and since we don’t know I can’t say for certain, was entirely monogamous with Smith, and apart from hanging out with LGBTI people (not actually a crime) did everything well.

Also, stop with calling this bisexual man gay.  Peter has said repeatedly that he’s not gay, and Smith’s erasure of that is so wrong.

And apart from the Telegraph actually publishing this awful bit of writing, it’s the bit at the end which adds to the harm:

Straight partners of gay, lesbian and transgender people can find confidential support…

That’s ok, bisexual people are definitely a figment of your imagination. I haven’t provided the link to the email address that appears at the bottom of the article, I am not convinced that providing it would actually be a wise move.

Ok, so that was the first of my rants.  The second article which I noticed pretty much erased bisexuals and called bisexual women lesbians was published by The Guardian, “‘Love is always complicated’: Elizabeth Gilbert and the rise of later-in-life lesbians”.

I want to be completely clear here that I accept that there are women who come out later in life as lesbians, and for their own completely valid reasons did not come out earlier.  I also want to state that I accept that people have the right to label themselves.

The last point I just made has the following thoughts from me though.  If bisexuality wasn’t so incredibly stigmatised as an identity, would more people who are attracted to more than one gender use the label?  There are plenty of other labels under the bisexual umbrella (as several of us call it) that are used such as fluid, pansexual, polysexual, etc.  I think that those who identify with any label that suggests that they are non-monosexual is likely to face the same stigma that bisexuals face.

Later-in-life lesbians – women who identify as lesbians or declare same-sex feelings in their 30s, often after serious relationships, marriage and children – have come more into the public consciousness in recent years, with a string of high-profile women publicly leaving heterosexual relationships for female partners.

“Or declare same-sex feelings”… so those who aren’t identifying as lesbians, and are probably bisexual.  The word bisexual does not appear once in this article.  Not once.  It’s so thoroughly erased that this article pretty much states that if a woman comes out as attracted to other women, she can only be identified as a lesbian.

This is despite the following lovely quote from Susie Orbach:

Susie Orbach, who spent more than 30 years with the writer Joseph Schwartz, and had two children with him, before marrying novelist Jeanette Winterson, writes in the Guardian on Friday: “We are finally beginning to recognise that sexuality is neither a binary nor fixed. That love, attraction, identity, attachment and sexuality are more layered and interesting than they have been allowed to be represented in the public space until now and that as their complexity is opened up to us, the crudity of realising you were always gay or always straight is for many people a nonsense.”

And instead of asking why women don’t want to be labelled despite the fact that it would appear that they are bisexual, and instead of examining how non-lesbian women in same-sex relationships find community and operate in a world where they are being mislabelled, we get:

Jan Gooding, chair of Stonewall and group brand director with insurers Aviva, said that women who shift sexuality later in life are often keen not to be labelled in any way – like Gilbert, who does not explicitly refer to herself as a lesbian in her post but rather declares that she loves another woman.

Gooding speaks from experience: she had been married for 16 years “to a very wonderful man” and had two sons when she fell in love with another woman, but said she feels very protective of her husband and children and previous relationship. “People find it difficult to believe that I could fall in love with a woman out of the blue,” she said. “But it does happen, people haven’t necessarily been holding out until middle age. This idea that everybody knows deep down does a great disservice to individual journeys.”

I would love for more people to seize the identity bisexual, to be like Peter and stay firm, insisting that they are bisexual, not gay, not straight.  To state that there is nothing wrong with being bisexual, and that bisexuality is just another sexual orientation along the spectrum that is human sexuality.  This is why I am out.  This is why I am visible.  I want people to know that they can be bisexual and happy, that they can be in relationships with bisexual people and be happy, and that finding community and belonging are important and healthy things to do.

One day the MSM will get it right, and I’ll keep ranting until they do.

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Breasts and cancer

It’s been a while since I’ve posted here, I’ve recovered from radiotherapy (harder mentally than surgery because you’re completely exhausted), I’ve travelled to India (will blog more about that later), and it’s almost Christmas.

I’ve been collecting some articles about breast cancer, the cost of treatment, what we die from young (women = breast cancer), how trans people need to be careful of breast cancer, and really what you can do to ensure that you catch cancer early and get it treated quickly.

Continue reading Breasts and cancer

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Cancer Update: Radiotherapy Day 6

So I’ve had a few days of radiotherapy now, and thought I’d provide a general update as to how it is.

So I rock up at the hospital, sign in and be advised if my appointment for the following day/week has changed, go to the waiting area, and hang about and wait.  The waiting usually isn’t for very long, and then I get changed into my hospital gown, go wait in the second waiting room for a few minutes, and then get into the radiation room.

So far I’ve only attended one of these appointments alone.  I’m very lucky I have the support of friends and family to keep me company in the waiting room, even if it is for a short period.

So in the radiation room I tell them who I am, what they’re treating, and lie down on a table under a big machine.

 

Not the actual machine at the hospital, just one like it from a site on the internet

As I’m getting treated for breast cancer, my arms are above my head and I’m holding onto some bars.  The technicians mark on my skin where I got some tiny tattoos, and then line me up under laser beams (I am high tech) to make sure I’m in the right spot for the radiation to be delivered.  Once they’re happy they leave the room and I get shot with high energy photons, twice, diagonally through my breast in order to avoid my heart.  It takes maybe 5 minutes.

I don’t have a problem appearing nude in front of people, so constantly being topless in front of the technicians isn’t a problem for me, I can imagine it would be for some people, particularly as some of the technicians are men.  All of the technicians are lovely, and highly professional.

My breast is beginning to redden from the radiotherapy, which is the expected side-effect.  I am after all getting constantly burnt with radiation.  It’s also a bit tender, which isn’t surprising as all the cells are constantly being damaged and then have to repair each day.

I have been warned that I might get extreme burns (blistering and/or skin cracking) as I progress through the treatment.  I don’t know if the burns will hurt as much as they will be annoying.  The hospital will keep an eye on any burns and side-effects to ensure that I am coping ok and provide assistance where possible.  I have already been provided with sorbolene cream to put on the irradiated area twice a day in order to keep the skin moisturised and soothed.

I’ve also had a cold/bacterial infection while doing this, so it’s been more shit than it normally would be.  I only have 14 more sessions left.

 

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Cancer Update #8 Radiotherapy Mapping/Planning

So this radiotherapy thing is becoming realer, and I’m getting more anxious about it.  It’s very easy to be flippant about these things when they’re off in an undefined time period in the future, but the moment it becomes real, the flippancy disappears and the anxiety settles in.

I’m more anxious about this than I think I was about the surgery.  I’ve had surgery before, I know what to expect (more or less).  I haven’t had radiotherapy.  Now that I know my radiotherapy date starting I will contact the people I know who have had breast cancer and talk to them about what to expect.  I don’t know how alarmist the radiotherapy doctor is being about being a fat woman having radiotherapy versus a thin woman (apparently I have a greater risk of skin cracking due to the burns I will get), or whether that is because I have larger breasts and I’d have that risk regardless of my weight.

Both the doctors who saw me today, the radiology doctor in training and the consultant weren’t particularly personable.  Their hands were FREEZING and I got quite cold as they poked and prodded my breasts before drawing on them in texta. I didn’t appreciate their talking about me as if I wasn’t really there, but I didn’t mind being part of a doctor’s specialisation education.

The nurses/radiotherapists on the other hand were absolutely delightful.  Their hands were warm, they were reassuring, they talked to me about what they were doing and how long things were going to take.  They apologised when they were about to touch me with something that was cold (mostly the ruler they were using) and ensured that I could get up and go to the toilet when I couldn’t wait any longer during the appointment.

So radiotherapy starts on the 22nd of September. A bit under 2 weeks away.  I will be going to the hospital 5 days a week (business days) for 4 weeks (barring sickness).  I may get very fatigued, I may burns that resemble severe sunburn, I may have none of those things and just have the inconvenience of my days interrupted with a hospital appointment.

I am a bit over the unknowns.  My life generally has a lot more certainty in it, and I prefer it that way.  But soon things will be back to normal (more or less).  I’ll start on the tamoxifen, work through the side-effects, and just be myself.

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Cancer Update #7 Radiotherapy Consult

So today I went and saw the radiotherapy doctors at the Peter Macallum Hospital, Victoria’s premier cancer hospital.  Before I talk about me, I want to talk about that hospital because it was one of the most amazing patient orientated places I have ever been.

The Peter Mac (as it tends to be known to everyone) is a bit of a maze.  That is a big downside when you’re stressed and confused and don’t know where to go.  However, once you get where you need to be – in my case the Breast Cancer clinic, the waiting space is absolutely amazing.  The various clinics are located alongside each other, with one big waiting room.  And what a waiting room it is.

I wasn’t there for very long, but this is what I saw.  There are jigsaw puzzles, with tables set up to do jigsaw puzzles on.  There is a big box of wool, with knitting needles and I’m guessing crochet hooks, so people can knit/crochet while waiting.  The supporting columns were all decorated with yarn bombing.  There were colouring pencils and adult style colouring pages.  There were board games and a chess board.  There was a library of fiction and non-fiction books.  There were magazines in many different languages.  There were comfortable chairs.  There were treadmills if you want to walk off anxiety or do your daily exercise.  There is also free wifi so you can browse the internet/read RSS feeds/play games on devices.

I know the Peter Mac is moving next year to a new location on Grattan Street, across from the Royal Melbourne and Royal Women’s Hospitals, and I hope they keep this very patient friendly and supportive atmosphere in their new building.  It was great to see so much creativity.  A little more on what goes on is here.

Ok, so me… I saw a younger doctor who initially told me I’d need 6 weeks of radiotherapy, and then went through my cancer diagnosis history and overall health.  I reported something* which I think might be related to the surgery I had, he wasn’t sure it was related, but I’ll speak to the breast care nurse at the Royal Women’s tomorrow anyway.  He took me through the not very likely, but serious risks of having radiotherapy, and then went off to find his supervisor – who is the doctor I’d actually been referred to see.

The supervisor doctor said that I’d only need 4 weeks (which is what the RWH had said), and that overall that’d be better for me as it means that it’s over quicker and the immediate side effects don’t last as long.  I will be called for a mapping appointment which will be in the next two weeks, and then radiotherapy will start two weeks later than that… probably.  Apparently the planning of how to deliver the treatment without impacting on my heart and lungs can take up to a week, so the radiotherapy won’t start as soon as I expected.  This is ok, I am not an urgent case. Given my cancer is at an early stage and appears to be completely removed from my body.

* I have some pain under my breast that seems to be as if some fluid (oedema) has formed as a result of surgery. It might resolve on it’s own, it might need to be drained.  I’ll get a second opinion, because it’s sore and that means that I’m not doing all the things I’d like to do otherwise.

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Cancer update #4 (one week since op)

I’m still here, recovering as well as can be expected really.  It hurts a fair bit, and when it’s not hurting it itches. I know that itching is a sign of healing, but it’s really irritating nonetheless.

The incision under my arm is about 8 times larger than usual, and it’s cut through muscle, so that’s the one that is causing me the most grief.  The lymph node was clearly busy hiding and not wanting to be removed.  I have most of the movement back in that arm now, I even was able to lie on my left side last night, so it’s healing slowly but surely.

I have almost one more week off work to complete the majority of healing, and an appointment with the hospital on Monday to go through the next treatment steps.  It’s unlikely that I’ll need more surgery (15% chance) or chemo (20% chance) so it’s more likely they’ll check how I’m healing up and propose a date to see someone about starting radiotherapy based on how fast I’m healing.

I’m somewhat anxious about Monday because I don’t know what is going to happen.  This is understandable and unsurprising.  I will be taking my partners along with me, who the hospital has been very good with, so I have all the support I need, and so they understand what happens next.

Mostly I’ve been spending time on the computer reading twitter, blogs, playing games, and spending time catching up on TV.  Lovely people have visited me and brought me gifts of tasty food, hugs and their company.  I have received flowers from friends, and calls from people checking in on me that I’m ok. I am very grateful for all the support and love, and it has really helped.

I’m looking forward to joining the Boob Club so I have a support network of people who’ve been where I am now (or who may be where I am now).  There is always the risk when you join a group of people with a specific interest that that may be the only thing that you have in common.  I’m sure I will find other women who are into social justice, queer rights, and cooking (not necessarily all at the same time).  That’s not too much to ask.

I’ve been thinking about Chally’s recent post “What not to say to someone in hospital, part one“, after a call I received from one of my work vendors (as in she’s the account manager for a company and I manage the contract between her company and my client).  She was asking me questions about how I was going, as she’d just found out about my diagnosis and surgery, and I was thinking that some of those questions were incredibly impolite.  I like her, she’s lovely, but asking me if the surgery involved the removal of my breast isn’t really something I’d ask someone I had a professional relationship with.  People are strange.  It’s that blurred line between working with someone for years (in this case about 5) and knowing each other well, and what the actual relationship is.  It didn’t upset me, I just thought it was inappropriate and something I need to consider for the future.

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Cancer Update #3 (post op)

So I’m sitting at home now, mostly able to type, much clearer headed, and healing.  There is a wide range of movement I can’t do, and I’m still figuring out bits of that.

I’ve been sleeping in our recliner couch for the past 2 nights as I have been worried that sleeping in my own bed would be too uncomfortable, mostly due to an inability to roll from side to side, and getting up being a real pain the side.  I might graduate to sleeping in my bed tonight, I don’t know yet.  My neck would certainly appreciate me sleeping in my own bed, but we’ll see.

I have two rather large incisions on me.  One under my arm where the sentinel lymph node was taken, and one where the tumour was removed. If I cared about such things, I’m fortunate that both of the scars (when they eventually heal) will be in non-visible locations.  I’m actually a little disappointed about that, I think that scars are cool.

The incision under my arm is the one that hurts the most.  This isn’t surprising as that is the location that sees a lot more movement (twisting, lifting, rubbing, etc).

Yesterday was a day of minimal food as I was still feeling nauseous thanks to the operation, pain and the drugs I was taking.  Today I feel way more human and I aim to try the delicious looking cake my sister has made for me. I also want to go for a walk around the block to get my body a bit more mobile and drop the neck pain I have.

I could go through the ins and outs of Wednesday (surgery), but I won’t (unless you want me to) other than to say it was a really long day, the staff at the Royal Women’s Hospital are fantastic, and that it was slightly worse than I expected it to be.

I won’t get the results of the biopsies of the tumour and sentinel lymph node until Monday week, so in the interim I heal, continue to be spoilt by my loved ones, and gradually each day become more and more independent.

Today I could undress myself, tomorrow I might even be able to shower on my own.  The wonders of a body which can heal itself from invasive surgery.

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Cancer Update #2

So today I went and got my other test results (blood test, biopsy of another anomaly) and spoke to the surgeon and breast cancer nurse about surgery on Wednesday.  I probably won’t be blogging immediately after the surgery, not the least because they’ll be operating under my left arm (in the arm pit) and that means that typing and the like isn’t on the agenda for a few days.

I’ll state this up front – this whole thing seems so unreal.  I am not obviously sick, I do not feel sick.  Apart from some pain where the tumour apparently is against the chest wall, I don’t feel like I have cancer – whatever that feels like.  Wednesday is going to make the whole thing a lot more real, and that’s both scary and reassuring.  Scary because cancer is scary.  Reassuring because I do feel a little like an imposter right now, because I feel mostly fine (just stressed).

Anyway – today’s visit to the hospital had my blood test results completely normal (with slight vitamin D deficiency which is unsurprising as it is winter), and the biopsy coming back completely clear.  We went through all the process for the pre-op stuff, told how much it’s going to hurt (a fair amount), and how much I’m going to have to wait (a lot), and reassured about some of the side effects, like the blue dye that is used to trace the lymph node paths will stain my skin – that’s normal.

Also we went through some worst case scenarios, just so I was across them.  The nurse was impressed that I was so calm and in control – that is my default state, I will probably fall apart later – and that’s ok too.

So a week off work (this week) and possibly some time of work next week to ensure I’m healing well.  A further biopsy of the tumour after it has been removed builds the next step scenarios.  Best case, I have 4 – 6 weeks of radiotherapy a month after surgery, and then on a drug for 5 – 10 years.  Worst case, I have additional surgery and/or chemo before radiotherapy and medication for years.

Yes I’ll probably keep blogging about cancer, because writing stuff down helps me sort through it.  I do want to blog about other things to, and once I’ve gotten the big bits out of the way, I’ll probably go back to doing just that.

I do want to say how grateful I am to have been born in Australia and eligible, thanks to my citizenship, to access free healthcare.  All of this treatment will cost me very little.  The medication will be the most costly part.  The operation, radiotherapy, and consultation visits will be covered by my taxes and the paid taxes of other people.  This is a fantastic thing, and means that I don’t have to ask myself if treating possible cancer is something I need to do or is it something I can live with.  I do wish people in other countries without “socialised medical systems” could access the level of care that I will be accessing for the cost that I will be paying.

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