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Dear Curi­ous,

Thank you for your com­ment on my pre­vi­ous post. As always, I wel­come any responses to what I write. To me, any response means that I’m effec­tively get­ting my words out into the world.

My last post did not mean to belit­tle Can­cer as a dis­ease. And yes, I real­ize that I was a bit over the top and melo­dra­matic at the end. I truly debated as to whether or not I should respond to you. But then I thought that I should really prac­tice what I preach.

And what I’ve been preach­ing lately is that it’s bet­ter to edu­cate oth­ers about Infer­til­ity than per­pet­u­at­ing a myth.

In this case, it’s the myth that Infer­til­ity is not a dis­ease, but rather just a “con­di­tion” that is a result of a “badly dealt hand” in life.

Or as Mar­garet Wente’s edi­to­r­ial in The Globe and The Mail indi­cates, “Many things in life are deeply unfair, and infer­til­ity is just one of them … … [In the] mean­time, record num­bers of peo­ple are embrac­ing child­less­ness out of choice. It seems that one person’s deep unfair­ness is another’s blessed liberation.”

So, as an RN Case Man­ager … who has not only taken care of many Can­cer patients at the hos­pi­tal and has fol­lowed up with them on an ongo­ing basis after they’ve returned to their homes … let me take the oppor­tu­nity here to dis­pell this myth.

1. Let’s first get our def­i­n­i­tions straight.

Con­di­tion: a usu­ally defec­tive state of health (from Merriam-​​Webster Online Dictionary)

Dis­ease: a con­di­tion of the liv­ing ani­mal or plant body or of one of its parts that impairs nor­mal func­tion­ing and is typ­i­cally man­i­fested by dis­tin­guish­ing signs and symp­toms (from Merriam-​​Webster Online Dictionary)

Can­cer: a term used for dis­eases in which abnor­mal cells divide with­out con­trol and are able to invade other tis­sues (from the National Can­cer Insti­tute website)

Dia­betes: a group of dis­eases char­ac­ter­ized by high blood glu­cose lev­els that result from defects in the body’s abil­ity to pro­duce and/​or use insulin (from the Amer­i­can Dia­betes Asso­ci­a­tion website)

Infer­til­ity: a dis­ease of the repro­duc­tive sys­tem defined by the fail­ure to achieve a clin­i­cal preg­nancy after 12 months or more of reg­u­lar unpro­tected sex­ual inter­course (as defined by the World Health Orga­ni­za­tion, as stated by the Amer­i­can Soci­ety for Repro­duc­tive Med­i­cine website).

2. Now, let’s dis­cuss the dif­fer­ence between a con­di­tion and a disease.

Many dis­eases started out as a being known as a “con­di­tion.” Dia­betes was a “sugar con­di­tion.” Asthma was a “breath­ing con­di­tion.” It’s not until sci­ence began to do more research to deter­mine the rea­son for its abnor­mal pat­terns in func­tion­ing that a con­di­tion came to be called a disease.

To me, this is why giv­ing voice to Infer­til­ity and edu­cat­ing the gen­eral pop­u­la­tion is extremely impor­tant: so that more research can be done to dis­cover how to effec­tively and con­sis­tently treat Infer­til­ity. And when I mean “con­sis­tently,” I mean that there should be a spe­cific path­way (or guide­line to fol­low) for treat­ment of Infer­til­ity. Much like there are stan­dards of prac­tice for treat­ment of the var­i­ous types of Cancer.

3. Now let me dis­cuss why I think all dis­eases aren’t fatal, as you’ve indicated.

Eczema isn’t fatal. Scle­ro­derma isn’t fatal. Dia­betes isn’t even fatal. What’s fatal is what hap­pens if appro­pri­ate treat­ment is not car­ried out. That’s when other health con­di­tions (or comor­bidi­ties) can add to the com­pli­ca­tions involv­ing the disease.

Going back to Dia­betes: If a Diabetic’s blood sugar isn’t con­trolled prop­erly, then this could lead to dia­betic nephropa­thy — or kid­ney dis­ease. This is caused by the kid­neys work­ing over­time to fil­ter out pro­tein from the body. Con­tin­ued over­work­ing can cause kid­ney fail­ure which could, again if untreated could cause tox­i­c­ity in the body, ulti­mately lead­ing to death. But would a pathol­o­gist con­sider dia­betes as the cause of death in a sit­u­a­tion like this? Likely no; it would most likely be kid­ney fail­ure as a com­pli­ca­tion from Diabetes.

Now, sub­sti­tute dia­betes in this sit­u­a­tion with, let’s say … pan­cre­atic can­cer. Again, pan­cre­atic can­cer could more likely be the com­pli­ca­tion in a fatal sit­u­a­tion such as this.

4. So now let me talk about why I think com­pli­ca­tions from Infer­til­ity can be fatal.

First there’s the idea of an abnor­mal repro­duc­tive sys­tem; which, like most dis­eases, could be caused from a vari­ety of dif­fer­ent sources. In this case, it’s dur­ing any part of the repro­duc­tive cycle. But just for sh*ts and gig­gles … let’s say that — in deter­min­ing the cause for Infer­til­ity — the woman dis­cov­ers that she has Ovar­ian Can­cer. Or we find out that the man has Tes­tic­u­lar Can­cer. Then I could log­i­cally assume (as you’ve pointed out) that Infer­til­ity can be related to Can­cer (or vice versa, for that mat­ter) and any com­pli­ca­tions that result from Can­cer can be fatal.

Or … how about this? Let’s say, in the quest to have a child, a woman who has put her body at risk to become preg­nant is sud­denly more at risk dur­ing her preg­nancy because of Pre-​​ecclampsia. And sud­denly it becomes evi­dent that a choice needs to be made as to whether to save the woman or her baby? I know women who have trag­i­cally been through this. And I hope, some­time in your life that you might have some empa­thy for them …

5. And finally, speak­ing of sym­pa­thy … I must point out that sym­pa­thy for my Infer­til­ity is not what I’m ask­ing from you … or from anyone.

What I really want is empa­thy. And that would mean that I’d want the under­stand­ing from oth­ers that Infer­til­ity is a dis­ease and it deserves to be rec­og­nize. It’s not some­thing to be swept under the rug or ignored.

And quite frankly, I would hope that a per­son with Can­cer would also want empa­thy rather than sym­pa­thy. For me, some­one who is sym­pa­thetic can only “feel” pity and sor­row for someone’s mis­for­tune. While a per­son who is empa­thetic has the abil­ity to rec­og­nize, com­pre­hend, per­ceive and directly feel the emo­tion of another. Seri­ously. I’d rather have some­one rec­og­nize and com­pre­hend how dif­fi­cult it is to be in my sit­u­a­tion than to just sim­ply say (per­haps in their head), “Too bad, so sad.”

So here’s one last set of definitions.

Sym­pa­thy: the feel­ing or men­tal state brought about by such sen­si­tiv­ity (from Merriam-​​Webster Online Dictionary)

Empa­thy: the action of under­stand­ing, being aware of, being sen­si­tive to, and vic­ar­i­ously expe­ri­enc­ing the feel­ings, thoughts, and expe­ri­ence of another of either the past or present with­out hav­ing the feel­ings, thoughts, and expe­ri­ence fully com­mu­ni­cated in an objec­tively explicit man­ner (from Merriam-​​Webster Online Dictionary)

So hope­fully you now have a bet­ter under­stand­ing of why I wrote my last post.

I’m not ask­ing for more recog­ni­tion than what Can­cer, with its mul­ti­tude of com­mu­nity sup­port, already has. I’m just sim­ply ask­ing for recog­ni­tion.

And finally … just so you know. I am a sur­vivor of Infer­til­ity … not because one of my par­ents suf­fered from Infer­til­ity (because my Mom did ) … and not because I ended up hav­ing chil­dren (because I didn’t) … I con­sider myself a sur­vivor because I was able to sus­tain years of treat­ment for Infer­til­ity and came out the other end of a ver­rry long tun­nel with my dig­nity (rel­a­tively) intact.

Best of luck in wher­ever your life takes you,
Emily

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