Friday, July 26, 2019

It's About Friendship


The novel I’m writing is about friendship. The main character is 12 when the story starts. It’s the first year of junior high school, 1977. Gemma meets the girl who will be her best friend because their lockers are close together. She hadn’t noticed Sylvia before, they didn’t have any classes together. 

It’s a chilly morning and Gemma has left her sweater on the bus. All she’s got on is a white T-shirt. A ninth grader cruises by with her bevvy of beautiful friends. She sees that Gemma’s nipples have hardened from the cold and announces to the crowded hall that Gemma needs a bra. Laughter. Gemma wants to crawl into her locker. 

Then from out of nowhere appears a big gray sweatshirt, handed to her by Sylvia. Some more teasing from the ninth grade Charlie’s Angels gang. And Sylvia plants a hard slap on the leader of the older-girl pack. This act lands Sylvia in the principal’s office and initiates a friendship for two girls who each reallyneed a friend at that stage.

I got the idea after re-watching one of my favorite movies. Take a look at this scene, in case you haven’t seen it. Enjoy, if you have:


One of the many things I love about the friendship in Bridesmaids is that it’s super clear that these women have known each other a long time. They have the benefit of knowing who the other person is under all the adult layers that develop over time: the career choices, partner choices and general trappings of adulthood that can often mask the essential person beneath. 

If we’re lucky we have a friend or a few friends like this. I am one of the lucky ones. I have friends who go back to junior high (yes it was called that way back then). I’m not sure when Annie (Kristen Wiig) and Lillian (Maya Rudolph) are supposed to have met, but it strikes me that, given their differences, they might not have become close friends had they met as adults. 

In the movie Lillian is about to get married to her super stable, nice boyfriend. Everything we see tells us that Lillian has her shit together. She seems happy. Annie, on the other hand, is off the rails. Her boyfriend left her after bakery failed. She’s has no-strings-attached sex with a guy who’s a real asshole to her (Jon Hamm). Throughout the movie she’s a train wreck, making one really embarrassing decision after another. It’s hilarious and sweet.

I started to wonder about Annie and Lillian, when they met, what their friendship was like in its earlier stages. They’ve got a solid bond so there’s no doubt that they’ve seen each other through some ups and downs. They trust each other. But they’re super different when we meet them. Time has passed. Life has happened. Lillian is in a good relationship. Annie is a hot mess in every way. And yet, there they are, planning Lillian’s wedding together (sort of). 

I wanted to write a story that goes back to the beginning of a friendship that will last through life’s changes, because I’m so lucky to have long-term friendships, with women and men. I see who I am through my friendships, and who I want to be. 

At this point I don’t think we’ll follow Gemma and Sylvia all the way up to a wedding—the story takes place over just a couple of years—but in writing them I can imagine who’ll they’ll become. Knowing that their unwritten futures include each other, that they’ll stay close friends through ups and downs, has helped me to figure out who they are as very young women. The fierce loyalty they have to one another will sit at the heart of their friendship for years to come.

Thanks for reading. It was fun for me to write this. (More fun than actually writing the novel…).    

Tuesday, July 23, 2019

Still in the Woods

My journey through perimenopause (so far)


I want to start off by saying that I’ve always been moody. Or at least a person who thinks a bit too much and can tend to get anxious. My 20s was a decade of ennui. And plenty of fun and adventure too, for sure. But let’s just say, going into this account of perimenopause and all of its accompanying challenges, that I didn’t start out a super sunny person. Who is, all the time? But I think it’s worth mentioning. Almost as if the hormonal changes of perimenopause sort of distorted and amplified my moods, more than created entirely new ones. (I'd like to note here that Microsoft Word doesn’t recognize perimenopause as a word.)

An example: While traveling in Europe in 1990 with my then-boyfriend now-husband Chris we would split up occasionally for the day. I remember a day like this in Prague. On that day I headed over to some touristy spot, I think the Castle, and met a guy while in a small gallery looking at some paintings. He was sweet and chatty and gave the impression of someone who just liked to be with people and have interesting conversations, so we spent the afternoon together, walking around looking at things and talking. I can’t remember where he was from, but he spoke excellent English. It was lovely. He reminded me of an ex-boyfriend. 

But that day was an anomaly. Most of the days Chris and I spent apart I would head to a café or museum with my journal (always with my journal) and brood, writing out my questions and observations and doubts and lamenting the fact that I was alone in a cafe writing in my journal instead of doing something worthwhile. It all led to lots and lots of filled-up journals, so I don’t really consider that writing to have been super “productive” (maybe because it felt like a substitute for interacting with people or exploring). I’m know I’m being hard on myself. Spending time alone writing is a perfectly fine thing to do. But I do see all that moody journaling as evidence of my nature: thoughtful, maybe to a fault. 

Meanwhile Chris, who had a guitar, would literally come back to our apartment with friends. Groups of them. Young men who liked music and were hanging out (usually East Germans who travel in packs when they’re teens) and who Chris could communicate with well enough to have fun. At least I enjoyed the benefits of Chris's social skills (and the magical way music brings people together).

It wasn't that I was a gloomy young woman. Back at home in San Francisco I loved throwing parties and have always had lots of friends and strong friendships. But the anxiousness that I (looking back) associate with hormonal changes crept into my life pretty early, compared to other women I know.  So with that in mind I pose the question: When did it begin? Where does the story of this transition start? It’s been physical and emotional and even spiritual, in a sense. It’s involved therapy and pharmaceuticals and disease and treatment and ongoing changes that are both so, so difficult and also empowering, revealing and transformative. 

It’s perimenopause, that transition that isn’t adolescence, but bears some resemblance. It’s not pregnancy. It’s the third big change. And it’s something to be endured, investigated and respected. It doesn’t offer gifts or gains like the first two transitions. Adolescence/puberty bring budding sexuality and fertility. Pregnancy brings a baby.  Menopause’s “gifts” or gains are very abstract. They’re hard to see, even impossible at times.

I'm going to use this space to explore the roots of my own perimenopausal transition, the hard stuff and what I've learned and gained along the way. I want to do this for two reasons: There isn't enough information out there about what women go through during this transition (science or anecdotal) and I want my daughters to have a sense of what I went through, in case it's helpful for them.

Next post: When did my perimenopause begin?

When Did My Perimenopause Begin? 

I’d like to find the thread, trace this transition back to its beginning, but I know this is a construct, since the beginning isn’t a clear place. It seemed to start and stop and then start again, sometime back in my life as a young mother.

If I’m going to identify a starting point it would be in 2003 when I first miscarried. Chris and I wanted a second child and were were lucky that getting pregnant wasn’t a problem. We were lucky with Sophia, our first daughter. That pregnancy went very smoothly. But the first try for a second child didn’t make it past 10 weeks. Then it happened again. Then a third time. My hormone levels had changed enough so that I couldn’t stay pregnant. 

The first time I used bioidentical hormones was when I squirted progesterone up into my vagina to keep a pregnancy intact. That pregnancy was Eliza, who is now 15, so it worked. I was very grateful for those progesterone suppositories. Very grateful to be able to “correct” the imbalance so I could stay pregnant.

Once I got out of the first trimester and it became clear that the pregnancy was likely to work, I was the happiest I had been, maybe ever. The miscarriages had left me feeling so very mortal. They were the first time my body had failed me, let me down, been unable to do what seemed normal and healthy. So as I entered the full bloom of the second and third trimesters I felt a joyful release from all that worry and surrendered happily to abundance. I remember waking up starving in the middle of the night during my second trimester. It was a rainy winter but I’d get dressed and drive myself to the Denny’s in Emeryville where I sat, happily scarfing down a Grand Slam Breakfast, surrounded by PG&E workers who’d been out repairing downed power lines. Good times. After that first breakfast (just like a Hobbit!) I’d head home and crawl back into bed.




So pregnancy agreed with me. And after Eliza was born I felt fantastic. My body seemed to have everything it needed to maintain an even mood (except sleep, of course!) and breastfeeding came easily. But once Eliza was about 1 or 2 I started feeling anxious in a way I hadn’t felt before. I struggled with a feeling of dread and small feelings of uncertainty or irritation became overwhelming. I remember feeling annoyed with our next door neighbor for draping some blankets to dry over the fence we shared. The feeling became so intense that I had to lie down and realized I was having a panic attack.

I would end up spending my 40s experimenting with different ways to manage anxiety: therapy, Prozac and eventually bioidentical hormones. It was a long rocky road and I wish, looking back, that I’d had better options, because none of the ones I tried really worked all that well. And some of them would contribute to major health issues later.

Next post: How the menopause transition challenges the notion of gender.

Monday, July 22, 2019

Menopause and Freedom From Femininity


A few friends who’ve read my earlier posts here have mentioned Darcey Steinke’s recent book, Flash Count Diary. It’s just out, as of July 2019 when I’m writing this, and I’m a little more than half-way through it. Steinke has mostly written fiction in the past (and I’m looking forward to checking that out) but with this book she explores the menopause transition with a combination of memoir and reportage. It’s a great read – satisfyingly intimate, as any memoir about menopause should be – and enriched by reporting. Steinke mines the limited research that’s been done on menopause and finds the scientists and scholars who are asking the question: why do women experience difficult menopause symptoms like hot flashes, insomnia and depression? 

She also looks far and wide to explore what lies on the other side of menopause (it is a transition after all, not a destination). In this way, the book offers a lot of hope and a new perspective.

Many women she interviewed, she shares, report that after menopause (or during perimenopause) they feel existentially lighter, freer to be themselves and less distracted by what other people think about them. This extends to both behavioral choices (Should I head out to the cafe to write my novel or wait and see whether anyone needs me to make them something to eat?) and physical appearance (Yep, there’s my tummy, hanging out over my shorts.). At the heart of Steinke’s discussion is a fascinating point: During the menopause transition, the whole notion of gender is in flux. Our femininity is mitigated by dropping estrogen levels, which can lead to lower libido, less supple skin, weight gain and so many other changes. What makes us “pretty” fades. But the good news is that, if we’re wise, we don’t really give a shit. We’re too busy writing that novel or (fill in the blank).

Part of being younger, for many women, is frankly being saddled by sexuality and its many pleasures and hassles. For women who are no longer looking for a partner, the frantic obsession with ass size, waist size and general attractiveness goes out the window. I can say this is true for me. I love clothes and for the most part I love my body, so it’s not as if I don’t care what I look like. But my care is more akin to an artist’s interest in what she can do with the medium and less like a saleswoman dressing the product up for maximum appeal.

This is a complicated shift. I’ve been happily partnered for more than 30 years. I’m not trying to find new partners or a mate and I’ve never been overly concerned about meeting expectations with my appearance. Since I was young I’ve liked an androgynous look (think Annie Hall with baggy men’s jacket, shirt and tie) but I realize now that I actually have been worrying about looking “right,” if not to attract men then to feel that I fit in and am following the fules.

My body is very different now than it was even three years ago. I’ve had a double mastectomy (more on that later) and I’ve gained weight around the middle. I’m less of an hourglass and more of a pear and I’d like to be able to say that I don’t care when pants don’t fit, but I do. I like my pants and I don’t want to have to replace them.

Me unaware that my picture was being taken. 
But most of all I don’t want to think about it.I don’t want to get onto that hamster wheel of trying to lose weight so I can look like I used to only to find that I can’t keep it off. Or really, I don’t want to stop eating bread. I did manage to lose 20 pounds a few years back on a cleanse that eliminated every possible food that I love, only to gain it all back and more. That’s not for me. 

It turns out that the medication I take as part of my cancer treatment (Tamoxifen) makes losing weight nearly impossible and my doctor says that if I can just keep my weight stablethen I’m doing well. So, for now, I’m eating what I want (she typed, taking a big bite of scone) and keeping up the exercise. 

And by the way: I’m in the café now, about to work on my novel, while my daughter makes her own breakfast at home.  

Next post: Did treating my anxiety with hormones contribute to my cancer?  

Sunday, July 21, 2019

The Toughest Lesson So Far


I started taking bioidentical hormones in 2009 to treat anxiety and depression. The information available at the time about the safety of hormone replacement therapy was just as useless as it is today: a mish-mash of research to show that yes, women can experience huge relief from hot flashes and mood issues and, oh yeah, they might also get cancer.

At the time my doctor recommended that I take the progesterone and estrogen (because I was still menstruating) but only for a few years, to be on the safe side. And at the time, to my great regret, I thought that was a fine idea. If it’ll help alleviate the anxiety that I just couldn’t shake any other way, I was up for it.

So I took progesterone tablets and rubbed estrogen gel on my skin every day. And I was less anxious. After three years I weaned myself off of it. So far, so good.

You know what happens next. In just the same way that I can’t be sure it was the hormones that reduced my anxiety, I can’t be positive that they gave me cancer. But I did get cancer and it was the hormone-fed variety. Even if the hormones didn’t cause the cancer, it certainly helped it grow. It’s possible, I suppose, that my body might have been able to address the cancer cells and flush them away had it not been for the hormones I was taking daily.

My breasts were very dense so I was going in for mammograms every six months. I had that last mammogram (I’ll never get another one) the day after we had dropped our older daughter off at college. It was September 2016. The doctor recommended a biopsy to look at an area that could have been fibrous breast tissue but could also have been cancer. 

I got the phone call later that week. I’ll never forget sitting with Chris in my doctor’s office while she drew a chain of milk ducts on the examination table paper. Some of my cancer was DCIS, in the milk ducts, but there were also stage 2 tumors. Chris says I was crying too hard to hear the doctor say that it looked like they’d caught it early. But I doremember saying, “It was the hormones!” And I remember her quietly saying that the hormones might have helped the cancer grow but probably didn’t create it.

Thanks.

The hardest part was all of the other tests that followed to find the full extent of the tumors. It seemed to take forever, waiting for results and then for my surgeon to decide whether she wanted to know more. It wasn’t long before I decided to have a double mastectomy. My feeling was that I didn’t want to have any repeats (in the breasts anyway). I just wanted all the breast tissue gone. Also, my breasts were huge and I didn’t exactly love them. (A silver lining to all of this that I’d discover was being able to take up running again. No more big boob pain!)

Then Trump was elected. The world skidded into a hell pit.

It wasn’t until December that I had my surgery. It went well and I spent long, drugged-out days napping and watching Mozart in the Jungle. Chris was my nurse and our cat was his assistant. I healed well because I slept a lot. 

After that, radiation for six weeks, which sucked. It was like getting a bad sunburn, coming home, liberally applying aloe vera, and then heading back to the beach the next day. And the next. And the next. For a long time.

I didn’t need chemotherapy but I am taking tamoxifen. Ironically, tamoxifen works by preventing any aberrant cancer cells in my body from bonding with the hormones I still create. A hormone blocker. Sort of the opposite of taking hormones.

It’s hard but also helpful to write about this. I regret using hormones. I believe that I might have found some other way to address my anxiety (which was not minor). But what’s done is done. 

To anyone out there who’s considering hormone replacement therapy for whatever reason I say, think long and hard about other options. Acupuncture. Herbs. Therapy. Anti-depressants. Cannabis. Hysterectomy (seriously). A shocking number of doctors recommend hormones for women just to keep their post-menopausal vaginas nice and moist. That right there is bullshit. Our bodies change. We should strive to embrace the changes because there’s no magic pill that will keep any of us young. It’s just not worth it. I’m not sure what this means for trans women, but I worry about them too. One thing I’ve learned: don’t mess with hormones.

All of this happened against the backdrop of an extended peri-menopause. My body changed a lot when I had the mastectomy, but there have been other, less dramatic, changes too. My skin is less elastic, I’m not as horny, I get hot flashes (though thankfully not terrible ones). 
After radiation, we headed to Kauai.

Interestingly I am also less moody and feel far more focused. As I write this I have to say I’ve never been happier. Post cancer, I’ve learned how to live more easily with uncertainty. I’ve learned how to avoid worrying about things that probably won’t happen (which is most bad stuff). Like comic Tig Notaro, I’m super happy to be here. It feels good to hear someone who's had cancer make jokes about it. Here's mine: My breasts were luscious, but then I found out they were trying to kill me.

Next post: The silver lining no one wants you to know about menopause.

Saturday, July 20, 2019

When Vasalisa Faces Baba Yaga With Grace



The pull of hormones is strong, probably stronger than any of us realizes. The desire to intimately touch another person and to have a child—we already know that these are driven in part by hormones. But there's more.

Women sometimes feel sad, angry and even inspired right before our period starts. During ovulation we might want more sex. Then there's the "nesting" phase of pregnancy, usually starting late in the second trimester, when many pregnant women start big projects to ready the house for baby. Baby needs a place to sleep, a place to have their diapers changed and for sure they need all the loose photos to be arranged in albums and for that hideous couch to get the heave-ho.

I've focused here a lot on the role that hormones play in the menopausal transition. There's no denying how potent they area, but they're not the only drivers of change in our lives. We're not just chemical machines (add more estrogen and watch her grow breasts!). We're spiritual and intellectual beings. I'd like to share some thoughts I've had about the spiritual and psychic forces at play during menopause.

She doesn't name it explicitly as menopause but in her classic Women Who Run With the Wolves Clarissa Pinkola Estés writes about womens' experience of initiation and realization that the world might not be what it seems. In telling and breaking down the old Russian tale of Vasalisa, Estés discusses so many things—developing and trusting intuition, the necessity of "killing off the too-good mother" (a doozy of a notion for those of us who are mothers) and meeting fear, danger and even death squarely in the face.
Vasalisa in the dark woods.

In the story, Vasalisa is a child. On her deathbed her mother gives her a doll. "Should you lose your way or be in need of help, ask this doll what to do." Vasalisa puts the doll in her pocket (yes, right next to her gut) and sure enough when faced with difficult decisions, the doll in her pocket gives her the right answer. What a lovely gift for a mother to giver her child: awareness of their innate wisdom.

But another read is to see Vasalisa as a woman in transition. In the text, it's puberty. But it could also be falling in love for the first time, expecting a child or going through menopause. Aren't all transitions the same in some essential way?

Let's follow menopausal, post-fertile Vasalisa on her journey. She's got a powerful tool in her pocket: her intuition. But she's also got something the younger Vasalisa didn't have: life experience.

So when, as in the story, she meets the "old hag" Baba Yaga in the forest she is prepared to face this odd, frightening power. Baba Yaga is, of course, a crone, complete with a hairy wart and a house that can run around the woods on its chicken legs. She is a wild woman and a perfect stand-in for the hairy, brook-no-fools menopausal woman that the world loves to fear and demonize.

In fact, Baba Yaga is the embodiment of instinct, lived experience and power. In other stories she is the keeper of the day, rising sun and night. To gaze into Baba Yaga's face, Estés writes, is to see the power of creation and annihilation at the same time.

Baba Yaga
Armed with her own intuition and experience, our post-menopausal heroine stands and accepts Baba Yaga, warts and all, just as she did when she was on the threshold of adulthood. She respects this great power, because ultimately some of that power will become hers.

Estés frames most of her analysis for younger women, but this book is so rich and so relevant for women of any age. I highly recommend it. We can all use permission, again and again, to leave our "too-good" selves by the side of the road, to stop smiling kindly when what we mean is to gnash our teeth in rage and disgust. We are all so very necessary, so needed, by the world and not just by our children.