The Mechanic’s Responsibility
Every mechanic needs a little help sometimes. Chevy the Kitten, helped by giving my plane a cat scan.
June 2019 - Chugiak, Alaska
ENGINE LOGBOOKS
You don’t have to be a pilot to know that any experienced mechanic can listen to an engine run and have an idea of what the problem is by the sounds it makes. The mechanic also listens to the airplane owner and operator for what they’ve noticed. They’ve spent countless hours with that specific airplane, so they clearly know when something isn’t quite right. Of course, every mechanic must do their due diligence, read the logbooks, pop the cowling off the engine, and look at it with their own eyes and perform the proper tests to be sure, but sometimes the best information simply comes from listening.
Today, I will share a story about my journey with chronic pain and the many times when doctors didn’t listen. Although there are many types of chronic pain of which you’ve likely heard, there are some types of chronic pain that aren’t discussed publicly for the shame they bring. Mine is one of those. So if you’re uncomfortable reading about sex and vulvas, buckle up (harnesses and lap belts are required during taxi, takeoff, and landing). A little discomfort is good for everyone, especially with a topic so important.
And I’m sure you’re thinking, “Bright, you said this blog was about MENTAL health?” As you’ll come to learn, I deeply believe that physical and mental health are inextricably linked. You can’t talk about one without the other. On top of that, seeking answers for my chronic pain was the start of my mental health journey.
ENGINE FIRE
2011.
I didn’t really recognize my chronic pain until I turned 18 despite having had it most of my life. At the time, I was in a long-term relationship with my high school sweetheart. Unlike many, we waited until I turned 18 to have sex.
I returned home from college for my 18th birthday and my boyfriend and I planned a romantic trip for the weekend. Of course, the anticipation was over the top. We enjoyed a day out on the town, dressed nicer than we ever had before, and ate well. When we returned to our getaway for the night, we quickly hopped into bed together. We knew little of foreplay or lube, but no education offered to us could have prepared us for how the rest of the night went down.
Everything fell apart within minutes of our first attempt. I was in excruciating pain and sobbing. Not knowing what else to do, I got in the shower and tried to use the warm water, or even the cold water, to ease the pain. As the months and years went on, we tried all manner of things to help. Most lubes made it worse. Foreplay didn’t save the day. Sex always hurt.
THE LONG LINE OF MECHANICS
2012.
I made an appointment with my first OB/GYN. I started to explain to her about having pain with sex. Before I could provide any context, she interjected with judgment in her tone, “You’re already having sex? How many partners have you had?”
I paused, a bit shocked, before responding “Only one. My boyfriend and I...”
She interjected again. “You need to be checked for STDs.”
I quickly tried to regain hold of the conversation, “My boyfriend and I have been together for years and neither of us have had sex with anyone else before.”
It was clear she wasn’t paying much attention as she ordered the labs to have me tested. Without looking at me, she replied, “Well, you probably just haven’t had enough sex.” Then she dismissed me.
My parents always taught me the value of prioritizing your physical health. They taught me the importance of preventative healthcare, and I had always had a positive relationship with the medical industry… until then.
I began to do my own research, trying to find out what was wrong with me. I read about vaginismus, vulvodynia, and vulvar vestibulitis, all different diagnoses (back in 2012) for vulvar pain and pain with sex. If these are words you haven’t heard before, you should be shocked, because this type of pain is actually quite common. According to the American College of Obstetricians and Gynecologists, as much as 75% of women have had pain during intercourse. According to the National Vulvodynia Association, as much as 16% of women in the U.S. have suffered vulvodynia at some point in their lives. Yet, there is little to no education about this kind of pain. And even worse, there is very little understanding in the medical industry of the causes or the solutions. Here is the National Vulvodynia Association’s current definition of vulvodynia:
“Vulvodynia, or pain in the vulva, is a chronic condition characterized by burning, stinging and stabbing sensations. It has been described as ‘having acid poured on my skin’ and ‘feeling a constant knife-like pain.’ For some, the pain is constant and impacts every aspect of their lives, while others primarily have pain only with pressure or contact, such as during sexual intercourse or prolonged periods sitting.”
While reading what was available online in 2012, I realized that the pain I suffered spanned well beyond sexual intercourse. Certain clothes, riding bikes, and sometimes no trigger at all caused me pain, but I had become so accustomed to it over the course of my life and my mentions of discomfort as a child were brushed aside by many adults. I didn’t even recognize it as a problem until then.
I diagnosed myself with vulvar vestibulitis, but still having respect for the medical practices, little to no trust in myself, and no idea how to stop the pain, I looked for more help. I tried to get an appointment with a different OB/GYN. This time, the doctor at least looked. After looking, she told me with an obvious level of skepticism in her voice, “I don’t see anything.” I tried to tell her about my self-diagnosis, but she didn’t appear convinced. She ordered me to do STD testing… again… and sent me away.
2013.
On to my third OB/GYN, I finally found someone who acknowledged my pain. She referred me to a pelvic floor physical therapist and suggested some lubricants that may not further irritate me. Those few ideas felt like a God-send. Wow! Someone listened and is actually TRYING to help me!
Side Note: Coconut and olive oils don’t have the longevity of other lubricants, but they work and don’t cause irritation! Thanks, God-send OB/GYN!
The pelvic floor physical therapist was well-meaning, but I knew quickly that the exercises she was putting me through would do nothing for my pain. This is not to discount pelvic floor physical therapy. I highly recommend it for vaginal pain, so if you’re someone who is looking for ideas but hasn’t tried this yet, give it a shot! I will talk more about pelvic floor physical therapy in another blog post one of these days.
2014.
I went back to the God-send OB/GYN after seeing no significant improvement. Not knowing what to do, she referred me to a urogynecologist, supposedly the best in the state of California and known for successfully treating pelvic pain. He was a blunt, military-trained doctor. He had zero bedside manner, but he gave me a diagnosis. Low and behold, I had vulvar vestibulitis. Shocker, right? How could I, the patient, have accurately diagnosed myself before any doctor?! I left with a couple of prescriptions and a follow-up appointment. The prescriptions provided some relief but not much. The follow-up appointment led to more prescriptions and another follow-up appointment.
2015.
As the prescriptions mounted, the side effects compounded and the pain was barely addressed. Now, I not only had pain, but I was numb to pleasure. At my next appointment, the urogynecologist told me I had two options left: spinal steroid injections or surgery to remove the portion of my vulva that was causing the pain. He told me that the surgery was effective in 25% of patients, but might cause even more pain if it was unsuccessful. With those odds, I opted for the injections. The process was an ordeal, and I saw no results.
Before leaving the last appointment, I asked him if he could refer me to anyone in Alaska, as I had just moved to Alaska and could no longer see him. He scoffed and bluntly informed me, “No, no one in Alaska will be able to help you.” That was the end of the conversation. I left deflated and hopeless.
Years went by and I learned to cope with the pain. It seemed like every doctor either thought what I was experiencing was in my head or was not a big deal. I learned to work around it. I read ideas on the internet, tried many things, and gave up hope of better. By that time, I had long broken up with my high school sweetheart and had fallen into a number of other relationships where I had varying degrees of satisfaction in my sex life. I had a strong distrust of doctors and still a strong distrust of myself after a long journey of being dismissed.
That same year, I started seeing someone who had a high appetite for sex. At first, I was able to bear the pain, but after we moved in together in 2017, there were many days, even weeks, when I was too sore to engage. My frustration, anxiety, and fear around sex were building at a rapid rate. How the hell could I reconcile craving something that caused me so much pain? My desire was shutting down.
2020.
By this time, my relationship was really suffering. My partner claimed the infrequency of our intimacy made him feel unloved. Every sexual encounter was forced, and I learned to completely dissociate in order to cope with the pain. My life felt like it was on fire for many reasons (COVID-19, toxic job), but my relationship strain pushed me to seek professional help.
I searched the internet for “sex therapist Anchorage Alaska”. I had no idea what a sex therapist was or what they did. In my wild imagination, I envisioned something incredibly intimidating… sex seems way too private for that kind of scrutiny… but I was up for whatever it took to improve my relationship and my sex life.
I finally found a therapist’s profile that resonated with me. I called her and left a message. Months went by and she didn’t respond. One day, she called me and apologized for her lack of responsiveness and agreed to meet with me despite having a full client list. Turns out, sex therapy isn’t really that different from regular therapy. Phew.
I showed up and I talked about my struggles (in more than just the bedroom) and this therapist helped me dissect my childhood and my critical life experiences. When I explained to her why I originally came to therapy, she wasted no time in pointing out to me that my pain was not in my head and that it might be one of the most important things to listen to in my life story. I had altogether stopped listening to my body decades earlier. This was the first time I truly felt heard when talking about my chronic pain.
At the same time, I started seeking out another OB/GYN. I was referred multiple times to an older gentleman. It immediately didn’t feel like the right choice, but in the absence of a better choice, I saw him. In my first visit, I explained to him my experience with previous OB/GYNs and having my pain dismissed time and time again. I explained my diagnosis, my previous treatments, and all the failures. I felt like he heard none of it.
“Let’s take a look,” he said with skepticism. I indulged, but didn’t understand why he needed to look. I gave him everything he needed to know. He took a cotton swab to my skin and told me to tell him when it hurt. He induced the pain I had already described. Through my teeth, I said “YES, THAT HURTS.”
He responded, seeming real proud of himself, “Good news, you do, in fact, have vulvar vestibulitis, but that name is outdated. We call all of that vulvodynia now.” I was infuriated.
LESSONS LEARNED
I promise my chronic pain story gets better, but I feel compelled to leave the story here today to give space for those who have experienced something similar (in any part of the body). In this society, we give high praise to medical professionals who go through a minimum of 8 years of training. They are supposed to know everything and supposed to be there to support us, but that isn’t the reality. Nobody knows everything. Medical professionals will always have so much to learn. And how do they learn? They listen to their patients, and they keep educating themselves. While being a doctor does not preclude you from being an excellent listener, it seems that skill isn’t really what doctors are taught. What an incredible shortcoming of the medical professions! An industry built to serve people often does the opposite, tearing down people’s sense of self and leaving them feeling alone and helpless.
Many of the doctors I’ve seen over my lifetime have certainly added to my sense of loneliness and helplessness. The many times that a doctor didn’t listen regardless of my protests also stripped me of a sense of agency and control over my life and body. It has taken a lot of work to learn to be a better advocate for myself in a world where women and minority voices are often dismissed by medical professionals.
Every good mechanic listens. Every good doctor listens. It’s their responsibility. If yours isn’t listening to you, this is the message I have for you:
Your pain is real. Your pain is not “in your head.” Your pain is not acceptable. Your pain is not the way you were designed to live. Nothing is “wrong” with you. You know your body better than any doctor. Maybe you’re stuck on the ground right now, but you deserve to be flying.
