Wednesday, June 10, 2015

Talking about your body parts could save your life. Really.

When I became a mother, I was determined not to use euphemisms in teaching my kids the names of their anatomical parts. I reasoned things out like this: If your elbow is your elbow but your penis is your pee-pee, eventually you're going to grow up and realize that your penis is, in fact, your penis, and you're going to wonder why your parents shrouded that particular part in the mystery of a fake name.

That strategy worked pretty well for the most part, except for the time Scott, at 2, began pointing and announcing to everyone in the grocery store, "He's a boy! He has a penis! She's a girl! She has a vagina!" And then there was the time he drew a penis on his gingerbread man at preschool much the way he had drawn elbows and a nose.

But for the most part, I was glad we had called things what they were, and neither child seemed to feel any shame or weirdness about any portion of his or her anatomy.

I grew up in much the same straight-shooting way, as did a lot of people I know; I was a kid in the "Free to Be You and Me" early '70s, after all. But it struck me this week that for some reason, as we reach adulthood, many of us seem to regress, shying away from calling things what they are. And that reticence can cause problems for some of us; believe it or not, it can even indirectly cost us our lives.

(A note here: If you're squeamish or hate it when writers volunteer too much information, you're going to hate this post, so you'll want to stop reading now.)  

A couple of weeks ago, I noticed an abnormality that I knew would need a doctor's attention. I made an appointment, but the doctor was busy, so it would take two weeks for me to be seen.

So, hypochondriac that I am, I filled those two weeks by reading everything I could about my particular issue. Of course, I ended up certain I had cancer, the way I always believe I do.

But I also was struck to learn this:

Because women are reluctant to check the areas gynecologists typically pay attention to -- and because once they find something strange, they're embarrassed to see a health-care provider about it -- many cancers of the reproductive tract are diagnosed so late that the prognosis is frequently horrible.

Let's think about what that means. Because as women, we shy away from checking parts of our own bodies -- and because we're reluctant to call the doctor's office and use the words "vagina" or "vulva" -- we risk our health. How can that be OK?

And it's certainly not just women -- according to many articles I came across, men are worse. And when it comes to digestive issues, both sexes are equally skittish; colonoscopies are such an effective tool, but because we can't bring ourselves to talk about our bathroom habits, we shy away from scheduling them.

Why is this? Chances are, it's at least partially because the puritanical ethics on which our country was founded have been passed down, intact, from generation to generation. Most of us don't consider it polite to talk about certain body parts in mixed company.

And we know the reason for that: sex. The body parts we feel uneasy talking about are the ones involved with sexual acts. And that's really ironic and really unfortunate because, unless you're truly an exception, those parts spend most of their time involved in things decidedly non-sexual. 

Who decided we can freely talk about elbows and noses but not about vaginas or testicles? If we're using those words in non-sexual contexts, what could possibly be offensive about them?

For years now, Eve Ensler's play The Vagina Monologues has been doing beautiful job of expressing what I'm trying to say here. By teaching ourselves to feel comfortable monitoring, and talking about, our own anatomies, we can only enhance our reproductive health. But hard as Ensler may have tried to change the landscape, we have a long way to go.

We're doing better when it comes to our breasts: Organizations that raise money for research have sought to de-sexualize breasts in recent years and urge a focus on breast health. Activists like my friend Bridget Pargulski tirelessly lobby legislators to legally require radiologists to indicate if a woman has dense breast tissue that could hide a suspicious mass on a mammogram. We're talking about breasts in ways that are not at all titillating, and that's certainly as it should be.

We need similar activism around the health of our reproductive organs. Here are some sobering statistics: When it's diagnosed early, the five-year survival rate for one type of cancer of the reproductive area, vulvar melanoma, is 82 percent. But because it's almost always diagnosed late, only 16 percent of women who have it actually survive five years. Similarly, according to the National Cancer Institute, by the time most cancers of the vagina are found, the mean survival rate is only 57 percent.

Both these cancers are rare. But if you have one of them, or one of your loved ones has been diagnosed with one of them, the fact that they're rare is of no consequence.

We can do better, starting with our parenting of young children; the website A Mighty Girl helps parents talk to young girls about their bodies. We "girls" who are a little older can find help from such resources as What's Up Down There? Questions You'd Only Ask Your Gynecologist if She Was Your Best Friend by ob/gyn Lissa Rankin. (And if you don't like those, just Google and find a million other resources.)

I'm not perfect when it comes to this stuff. Often, when I find something odd on my own body, it takes me a few days to muster the courage to make a doctor's appointment; in my case, it's because I always assume the news will be bad,

But as my doctor and I were finishing our conversation today, she said, "You did what you should have done; you checked your body, and you saw something wasn't quite right, and you got here right away. We can't ask for more than that."  

Sometimes that's not enough; many diseases are way too cruel to care how vigilant a person is. You can monitor yourself and still miss things; you can catch things that are so aggressive that your carefulness is of no consequence. 

But any time we can stack the deck in our favor, we need to do it. Check your body, use the words, and, if you need to, call the doctor. It's not always that easy, but sometimes, it really, really is.