Post Birthday Diplomacy

Many thanks to all of you for your good wishes. In fact it turned out to be the best birthday I’ve ever had – and all because I hadn’t planned anything.

I saw all my nearest and dearest friends (the ones that live locally) and had phone calls and flowers and presents so I feel very spoilt. And one of my best presents was a large Roget’s Thesaurus from my oldest brother which he and the whole family each wrote a personal message in. As I will use this every day for the rest of my life, I couldn’t have a better present. And I will think of them every time I use it.

But back to everyday matters. This morning we picked Annie the sheepdog up as usual at 8am and drove up to the castle to walk her and Mollie. We arrived at the same time as two older ladies who walk their dogs and as Annie knows them, we walked together this morning.

It was fascinating. Himself walked with Margaret, the older of the two who, at 87, strides forth for a good walk every morning and repeats it in the afternoon with her rescue Cairn terrier, Dougal. She talks energetically and without pause for breath, in a lilting Scottish accent that is soft on the ears. (Though with Himself’s hangover I suspect it could have grated a little.)

Being smugly hangover free, I walked with Jan who must be a mere lamb at about 70 I would guess. She has a rescue King Charles Cavalier with heart problems and we were talking about what we did with our dogs when we went away. In our case we don’t go unless we can take Moll, having traumatised ourselves and her on the one occasion she did go to kennels.

Jan had a unique solution. “My ex-husband is friends with my current husband,” she said chattily. “So when Peter and I go away, my ex moves into our house and looks after the dog, the cats and the fish. We do the same when he and his wife go away. It works very well.”

I was almost speechless. Talk about diplomacy.

Birthday Celebrations

Today is my birthday. How did I get to be half a century?

How is it that when I look in the mirror I see me, but an older version, with wrinkles round my eyes, the same brown curls but with grey hairs spread among them? (More grey hair than my mother, god dammit.)

Inside I’m still the little me, the teenage me, the me that wore very short skirts and dungarees, platform heeled shoes and – jeans. Never been a follower of fashion, me. But also inside I know that I’ve changed and that’s one hell of a relief. The teenage Flowerpot was not a happy soul, to put it mildly.

I now have more confidence, a lovely fella, my furry family and great friends. I love what I do and I live in one of the loveliest places in the world. And I’ve had two work commissions in the last week which is a wonderful present. Keep ‘em coming…

I hadn’t planned any celebrations, not being a party person, but somehow things seem to have crept up. So Himself and I and some friends are having a quick bite to eat at Miss Peapods, a very bohemian café nearby that is great for people spotting and then Viv and I will take young Moll for a good walk, work permitting.

In the evening we’re meeting some more friends for a drink and then we will go home and sit in front of the fire with Moll and Bussie. Hopefully not the intruder – he’s not invited.

As you will have gathered, I’m not a party person. I’d rather spend the day with my nearest and dearest. Having said that, I have been persuaded to have a weekend with my cousin who’s also 50 this year and her son who’s 21. God knows when that’ll be though, given her social calendar.

And next week we’re having a girl’s night out and will go for a meal.

And my mum’s coming down on Saturday for Mother’s Day so we can have a joint celebration.

That’s the way I like it. Not one big party but lots of little ones.

Make of that what you will. Cheers!

The Hunt for the Intruder

The challenge to catch the intruder has escalated.

Yesterday we locked the catflap one way so that he couldn’t get out once he’d got in.
In case you’re wondering, Spoilt Only Son had the door opened for him. I regret to say this is not unusual.

Typically, there was no sign of the ginger intruder until at 5 o’clock this morning Mollie thundered down the corridor into the kitchen and we heard a CRASH of the catflap. Silence.

Himself trotted down the corridor clutching a rolled up newspaper muttering, “I’m going to give the bastard a fright.” Fear not, he would never hurt an animal. This is the man who picks up worms in the street and gently lays them to one side.

I lay in bed listening. He went into the kitchen, turned on all the lights, looked round. Then he came back, saying, “bastard’s broken the catflap. Must have a bloody sore head.”

The cat flap is still functioning – as long as you don’t want to lock anyone in or out of course. Those lock bits have been broken off by ginger cat now with a large bruise on his nose.

Earlier this morning I was writing up notes from an interview I did yesterday when I looked outside and who should I see nudging his nose in through the catflap but – yes, you’ve got it.

I thundered down the corridor yelling, “GRRRRRR” or some such deterrent, and emerged in the kitchen closely followed by a bemused Mollie.

Once again no sign of the ginger fella. He must have beat a very hasty retreat.
Still, Moll and I make a great team. Two stroppy women with unruly hair. Felons beware.

The Intruder

When we came back from Devon the other weekend the flat smelt of cats pee. For those of you that are fortunate enough not to have encountered this smell, it is like raw ammonia mixed with rancid eggs. And it lasts.

We presumed it was Bussie marking his territory while we were away, and having flung all the doors and windows open, after a few days it passed.

Usually Mollie can hear any intruder and belts down the corridor barking her head off, but yesterday afternoon both she and Bussie were snuggled up in front of the fire watching television.

I ran down the corridor to get the phone when I saw a strange ginger cat up on the table eating Bussie’s food. I hollered. He turned and poured himself through the cat flap (he’s a big cat) before vanishing up the steps.

Minutes later the hall reeked of cat piss. Then the bathroom. And a spot in the kitchen. I opened the french windows in the kitchen and gave it a good blast. That got rid of the worst of it, but we need to buy some extra strong air freshener.

Spoilt Only Son doesn't seem to want to seek revenge, whereas Himself is on the warpath. He's locked the catflap so that once The Intruder comes in, he'll be stuck in the kitchen and Himself can Deal With Him.

In the meantime, has anyone any tips for how to get rid of cat piss?!

Well, what do you expect from this blog? Scintillating humour and tales from an urban life? This is gritty real life. And a smelly one today…

Of Coughs and Cornets

What is it with men and coughs? Last time he had one, two years ago, it developed into a really bad lung infection which meant X rays and all that. It turned out he has pulmonary fibrosis. Not too badly, but bad enough for the consultant to be concerned about his lungs.

At the time I looked it up on the internet and read: This is a terminal disease. You can imagine how I felt. Thankfully it’s not that bad, but beware of the internet for matters medical.

Anyway, last week he had a cough for four days and by Friday had coughed all day and night. Would he go to the doctor? Would he hell. However, having endured the coughing all week, and with a friend coming for the weekend, I told him that he was going to get cough mixture on the way back from walking the dogs Or Else.

“It’s not fair on Pam or me, or you,” I said, then delivered my trump card. “If you’re not careful, you won’t be able to play in the band on Sunday.”

That did it. I got the cough mixture for him and by that evening the cough had almost gone.

‘That cough mixture’s worked well, hasn’t it?’ I said.

‘Don’t be silly, Pop,’ came the quick reply. ‘I told you it was getting better anyway.’

Silly me.

However, the gig last night went really well. He had a brilliant time, was well applauded and is all fired up about it now.

Roll on the band eh?

Dan in Real Life

Last night, reeling with exhaustion, I met a friend and we went to see Dan in Real Life, starring Juliette Binoche and Steve Carell amongst others.

As a piece of lowbrow entertainment it was great. Highly implausible plot but with good characters and set on a weekend family get together – and as most of us know, all kinds of crazy things happen when you let loose an entire family including children, grandchildren, a whole load of brothers and their wives and girlfriends.

When my mother’s tired or depressed she always wants to read books “with large print and a happy ending”. This was the filmic version of that but with some very real scenarios of family difficulties.

There are interesting parallels between the widowed father trying to cope with his eldest teenage daughter discovering Lurve (ie sex) for the first time, and him grappling with Lurve (not yet sex) for the first time since his wife died.

A good piece of escapism like a few glasses of plonk. Slips down easily, lifts your mood and no hangover afterwards.

Missed Dog

I’m gritty eyed from three hours’ sleep last night. No, not from a night of wild and passionate sex but due to an overactive brain and Himself coughing for most of the night. Now I feel light headed and other worldly. My brain is in there somewhere, but it’s far away, gone on walkabouts. I don’t expect it to reappear for a while.

I was tempted to lie in a bit this morning, but we had to collect Annie the Old English Sheepdog at 8am. When we got there, Betty’s gate was locked and there was no sign of her car. This seemed a bit strange but I figured perhaps she’d already gone up to the castle (I didn’t consider how she might have got out with the dog when she’d locked herself in which shows the state of my brain).

Thinking that she’d misheard the arrangements, we drove up to the castle which is a 10 minute drive. It was a beautiful morning, the sun was warming the dew and there many dogwalkers about – but no Betty and Annie. Himself swept round the car park and silently and at considerable speed, drove back here.

This time her gate was open so I ran down and knock on her conservatory door. Nothing. I went in and knocked on her locked kitchen door. Silence. No barking from Annie.

I returned to the car where Himself glowered silently. We drove back to the castle, again in silence. Hoorah – Betty’s car was there, though no sign of her or Annie. We walked Mollie round the castle, figuring that we always meet them somewhere along the way – she likes to go anti-clockwise, so we went clockwise, walking faster and faster.

Himself’s cough did not improve with all this activity, and as we got back to the last part of the walk, we saw Betty in the distance get back into her car and drive off.

A lot of muttering followed which I’m sure you can get the drift of, and we drove back here to find no Betty. I wrote her a note explaining what had happened and asked her to ring us.

She did, half an hour later, very contrite when she realised she’d locked us out, and that we’d been driving round Falmouth for the best part of an hour. Unfortunately the whole point of the exercise was to get Annie used to our car and us before Betty goes away. Sometimes the best laid plans just don’t work out.

But we have a friend coming for the weekend who’s a professional dog sitter with a passion for big dogs. I foresee love at first sight.

And now - is it bedtime yet?

Winter Swimmers

Falmouth is hellish when an easterly blows – you go out of the house and it feels as if someone has thrown a bucket of iced water in your face. It trickles down your neck, gets up your nose, in your eyes and up your sleeves, whips all the heat from your body. And because our flat faces east, all the heat is sucked out of our living room windows making the flat freezing.

But this morning, after over a week of gusting easterlies, the wind has dropped and we all heaved a sigh of relief and headed for the beach this morning where the tide was out and the sky and sea melded together in a haze.

Six swimmers were in the water. The winter swimmers are stoic, mostly over sixty or seventy, and swim every morning, regardless of the weather. This morning I spoke to Dominic, a poet who shared the moments of TV Fame back in December and asked him why he did it.

“It gets me going in the morning,” he said, pulling his jumper on over salt sticky flesh. “I can feel the salt on me for the rest of the day. And I seem to have avoided any colds or flu.”

His eyes are dark and bright and his skin was glowing, so he must be doing something right. I remarked on how many people there were this morning and he grinned.

“It’s a sign of global warming,” he said. “You used to measure the swallows in your garden. Now it’s winter swimmers.”

So now you know - want to keep fit? Get swimming. Personally, I'll wait until it warms up a bit.

Good news

Himself had his latest PSA test last week (for his cancer) and the results have come back.

It’s down to 1.8 which means he can stop taking the medication for a few months which is excellent news.

The medication certainly halts the cancer, but the side effects are numerous. Hot and cold flushes, depression, weight gain and severe joint pains are just a few.

But what most people don’t talk about is the fact that it causes impotence. Yes, that scary word that no one – particularly men – like to talk about.

In non medical terms, prostate cancer is caused by too much testosterone in the system, so if you knock that out, the cancer will stop growing.

So you can either get treatment and say good bye to your sex life. Or - well, I don’t need to spell it out do I?

But we had the good news yesterday, which means that in about a month’s time (when the drug has worked its way out of his system), we will be firing on all cylinders, so to speak. (How delicately put is that?)

Flowerpot now has a smile on her face.

Annie and Toenails

On Thursday we go and collect Annie, an Old English Sheepdog who belongs to a friend of ours down the road. The indomitable 82 year old Betty, Annie’s owner, is going on a cruise for three weeks and rather misguidedly, at Christmas time I volunteered to walk Annie in the mornings. (Betty’s son is staying in her house while she’s away to look after Annie but being a breakfast chef he starts work at 6am so can’t do that shift.)

I’m rather wishing I’d kept my trap shut to be honest. Annie’s a darling but it is quite a responsibility looking after someone else’s dog – what if she was ill or ran away (God forbid)?

I’m sure nothing will go wrong but note to self. Think before opening mouth. Some hope.

On Saturday we were walking down the High Street and passed the barber’s shop. The shop next door to him has been empty for a while and now looks as if someone’s about to set up a new establishment.

“It could be the barber’s wife,” said Himself. “She does toenails and that sort of thing.”

When I’d finished hiccuping from laughter, I said, “toenails? You mean manicurist?’

He grunted and strode forth. “Manicurist?” he said. “You expect me to be able to say that at this time of the morning? Toenails is bad enough.”

I was laughing so much by this time I could hardly breathe, but managed to say, “I don’t think you’d get many customers if you advertised as Doing Toenails.”

“Don’t see why not,” he said, undeterred. “Manicurist sounds a bit bloody snooty.”

So there you go. Remind me never to ask my husband to become my publicist.

Cornets and Frivolity

Today The Other cornet arrives.

Yes, he bought it at nine twenty on Wednesday evening. I returned from rehearsals for Pajama Game to find a flushed and highly emotive husband crouched over a hot laptop, a glass of wine by his side (by no means the first).

‘Look, Pop!’ he said, and proceeded to tell me, in great detail, the ins and outs of this particular purchase. I’m afraid my interest lagged a little, as he’d told me most of it several times that day.

But at least yesterday I managed to sell the cornet that wouldn’t sell on ebay. Oh, the power of forums. (What’s the plural of forum? Forae? It doesn’t sound quite right.) Anyway, I advertised this cornet that no one wanted and blow me down, a couple from Porthleven came at lunchtime and bought it for their grandson. As he’s five I felt this was a bit optimistic, but never mind. It needed to go.

So when this new one arrives Himself will have a mere three cornets rather than four, which is an improvement of a kind I suppose.

Unfortunately one of the lenses fell out of his only pair of distance glasses yesterday so most of the profits have been spent on buying two pairs of glasses. He rather foolishly let slip that the optician had told him he should be wearing glasses all the time, so I insisted that he had a spare pair. So two pairs (with OAP discount) was £50, we both put £20 in the Frivolity Box and – er – the rest will go on housekeeping.

No comment.

I should explain about the Frivolity Box. This is a heart shaped tin that once held something smelly I was given for Christmas. A few years ago, my dear Sister In Law came to stay, and left some money for us to go out to lunch after she’d gone. Rather than put it in the housekeeping, where it would be swallowed up on toilet paper and soap, we put it aside and saved it for when we felt like a treat.

So now we try and have something in the tin for if we want a takeaway or go out for a meal. The tin’s got down to about three quid which doesn’t allow a lot of frivolous behaviour, so now it’s bulging with nearly fifty quid which means we can do something for my birthday.

In the meantime, Himself said cheerfully, “Well, I can’t buy any more cornets, Pop. I’ve run out of money.”

Since when has that ever stopped him?

Valentine's Day

many thanks to AOJ who nominated me for this award. It is highly suitable for Valentine's Day and I therefore donate it to anyone of my regular bloggers - I wouldn't read yours if I didn't enjoy them!

And on the note of Valentine's Day - I got a card, a bunch of pinks and two packets of bulbs - freesias and Dicentra, which is something that I've never heard of before.

It has lots of very beautiful heart shaped red flowers encircled with white (or it does on the packet) rather like a Japanese type of flower. Or how I imagine a Japanese flower would look like. Delicate and numerous.

By the time I plant it and it comes up, I will long have forgotten its name. You can tell my sort of gardening - I love my tubs but I tend to get things, bulbs or whatever, and stick them in, forget about them and celebrate when they come up. It's such a lovely surprise.

But back to the presents. We never usually "do" Valentine's Day so I'm afraid my dearest has caught me on the hop. I got him a card - of a close up of a dog that looks a little like the other woman in his life, but with a bow round its neck. Very cute.

I pondered over a present. Usually I get him things and he gets embarrassed because he hasn't got me anything (due to finances: he's the most generous person in the world). So I was going to get him a pair of trousers in the sale and then I thought no. He'll only huff and puff. So I went into Marks and they had heart shaped packets of chocolates - which neither of us eat. They give him mouth ulcers and make me hyperactive.

Chocolate out.

Fizzy wine? No, both of us loathe champagne or anything fizzy.

I went into the men's department and they had wallets - he has one. A bow tie. Excuse me - this is the man who doesn't even possess a suit... Aftershave? He never wears it.

So I walked home past the health food shop and suddenly I thought, I know! And I ran inside and there I found exactly what I know he will love.

A packet of dried bananas.

You may mock but he started eating them at 2 minutes to 7 this morning.

As I put the packet on one side, I looked over at the Dicentra packet and noticed its English name. Bleeding Heart.

Think he's trying to tell me something?

Awards and Buster II

I’m very chuffed to be awarded this from both Laurie and the Rotten Correspondent. Many thanks to you both. I won’t nominate others, but you know you deserve it – please take it and display it proudly!

On Sunday morning we walked Mollie down at Steamer Quay, by the river in Totnes.
The tide was up the highest we’ve ever seen it; nearly bursting its banks, and up and down the river the Dart rowing team were out practising in their skiffs. Tiny female coxes roared instructions at the eight men puffing and blowing as they pulled their oars in and out of the water with varying amounts of skill.

We met a lady with three dogs of indeterminate origin, one called Buster. A collie cross with milky blue eyes – he had trouble seeing.

We stopped and chatted, as you do with other dog lovers, and she told us that she was fostering Buster.

“His owners couldn’t cope and wanted him put down,” she said.

I caught my breath, horrified that someone could think of doing such a thing and she saw my anguish, nodded in agreement.

“Someone took him to the Animals in Distress rescue home in Ipplepen and I said I’d foster him.” She pointed to Buster trying to chase Mollie, unsuccessfully. “He enjoys life - apart from his awful arthritis,” she said. “It was so bad when he was in kennels that they had to lift him up each morning. But now he’s with me I’ve got the heating on at night and he’s much better.” She groaned. “I dread to think what my heating bill will be like!”

We stayed and chatted for a while longer before walking on, and she took her brood off in the opposite direction.

I won’t forget her – thank God there are people like her around.

Oh no, not another....

In haste as I am having a quick breather before meeting a deadline. (Yes, RT, I will meet it!)

I caught Himself pounding away on the laptop at seven this morning. This can only mean one thing…yes, you’ve got it.

‘You’re not looking at another cornet, are you?’ I said in tones that would have daunted a lesser male.

Nervous giggle. ‘Well, Pop I couldn’t turn it down. It’s only thirty five quid including postage.’

‘I thought you said you weren’t getting another cornet.’

He frowned and sipped his now cold tea. ‘Well, no, Pop but this one’s different.’ He tried another tack; anything to melt his wife’s cold heart. ‘It’s like a stray dog, darling. I couldn’t say no.’

'We'll have to move house,' I said. 'We haven't got any room for any more cornets.' I despaired and went off to make toast. He came scurrying down the hall like the forementioned stray. ‘I won’t buy any more, Pop. Promise.’

‘You said that before.’ Mountains wouldn’t move me.

‘I could cancel my Paypal account,’ he added in desperation. ‘That’d stymie me.’

But somehow I don’t know that it would.

The search for fame?

I need help from all you bloggers out there.

I need to find several couples that work together who DON'T live in Cornwall.
(There is an abundance of highly creative spouses in Cornwall but that's no good - I need them spread wider afield.)

These people have to be over 35, living anywhere in Britain and work with their spouse (though they don't have to be married?.

If anyone knows anyone, please email me on flower.pot@btinternet.com - my deadline is Tuesday afternoon!

Will post more when I have time - in haste!

Songs on the Brain

This morning I woke up singing Leaving On a Jet Plane.

For those of you under a certain age you probably won’t remember this gem, which was written by John Denver in 1967 (a fact I had to look up on Wikipedia – you can see how bad my memory is).

Quite why this particular tune decided to drag me into consciousness at six am on this particular Friday I have no idea. I didn’t hear it on the radio or television yesterday, and I hadn’t been talking about John Denver (in fact I could have sworn it was by someone else) but we are going to see my mother this weekend. This involves a car journey though, not a plane, and we most definitely are coming back on Sunday.

But a dear mate of mine is flying off to Egypt on Sunday for a much deserved week off. So Carole, I will think of you sunning yourselves on that beach, raising a weary arm to get yet another cocktail, while some of us slave over a hot computer, or walk the dog in the dank greyness of a February afternoon.

(Actually, I’m quite content and having to sit still for more than five minutes would cause me serious grief, as she well knows. But I wouldn’t mind a bit of hot weather and swimming.)

So Leaving on a Jet Plane is for you, Carole, and have a good one.

The day before I had songs from Pajama Game on my brain. I couldn’t make it to rehearsals, but the songs just popped up, to remind me, anyhow.

What was the last song you had on your brain?

Lost for Words

Over the last few weeks I have heard of two people who have been diagnosed with cancer. One is a dear friend’s father who has not been given long to live. My mate sent me an email saying she couldn’t talk right then but would ring later. She rang and I was speechless. Apart from saying I’m sorry, she started crying and I did too. Absolutely no comfort to the poor thing.

The other was a dogwalking friend whom I don’t know very well. I got out of the car to walk Moll early this morning and there was Olga, looking very pale. I asked if she was all right and she said, “I’ve had some bad news.”

I asked what it was, and she said, “well, you know I’ve had breast cancer and had both breasts removed.”

“No,” I said, my heart sinking.

“I heard yesterday that they’ve found more cancer and it’s spread.” She looked at me uncomprehendingly. “I’m flabbergasted. I didn’t ask the right questions and I can’t believe it.”

I gave her a big hug and said I was so sorry – what stupid words, meaningless, trite and worthless. And I cursed the lack of words – but what do you say? Our language is like food nowadays; there’s too much choice, we overuse the ones that are bad for us and don’t select high quality ones of real meaning. We use takeaway words that are pre-selected, bantered by the media and served in the chiller department, easy to grab, easy to use. Mixed metaphors? You'd be mixed if you were served up cancer.

When it comes to a disaster, we don’t have the right ones to hand. Or we’ve forgotten how to use them.

Or perhaps a cuddle is better than words?

Soaps

Last night we watched the penultimate episode of Mistresses which, for those of you that don’t watch it is about – er – mistresses. Clever, that.

I should explain here that the reason why I’m amazed that Himself has got so hooked on this programme is because he doesn’t watch soaps. At least, that’s what he says. His older sister reliably informs me that he was hooked no Neighbours many years ago, but he vigorously denies this, of course.

The plotline for the series is four women who are involved with various men and all in deep trouble.

Katie had an affair with one of her terminally ill patients and, when he begged her to help him end his life, she did. She then went on to have an affair with his son and finally told him what she’d done. Being a thwarted male, he spilt the beans, told mummy and Katie has now been suspended pending a court case.

Jess works for a party planning company and is having an affair with the boss. But when she organises a civil partnership, she slept with one of the women on her hen night. They start seeing each other again and she realises she is deeply in love.

Trudi’s husband Paul was killed on September 11th, she believed. But now a strange woman has turned up saying her son is Paul’s and now that Trudi has won a million quid on the lottery, she wants some maintenance. Trudi is now involved with another man but getting cold feet. She finally decides to give the woman some money and gets to the hotel, waits for hours and then sees her ex-husband running in with this woman and her child.

Siobhan has been trying to have a baby with her husband Hari for ages. As the marriage goes sour, she has an affair with a younger man at work, but when she discovers she’s pregnant, she lets Hari believe it’s his. The bloke at work realises, is livid and tells her where to go. Overwrought, she tells Hari the baby isn’t his and he is horrified.

So there you have it. Writing this summary, it reads as trite rubbish. I have trouble believing some of the situations, and I have no idea what message the programme is trying to convey. We presumably have to wait for next week for that.

But the writing is excellent; each week there are incredible twists and turns in the plot and the tension is racked up by the minute which all makes for very watchable stuff. We have been glued for the last five weeks and I can’t wait for next Tuesday.

Himself was just as keen until in bed last night when I said, “It’s a good soap, isn’t t?”

“Soap?” he cried hotly. “It’s not a soap!”

I hotly asserted it was, and this morning looked it up. According to Wikipedia, “A soap opera is an ongoing, episodic work of fiction, usually broadcast on television or radio.”

I told him and he listened in silence. Then he said, “I think it’s better than a soap.”

Sometimes, I wonder…

Adenomyosis

This has just been published in Nursing Standard (this week's edition) so has to go into the portfolio. Everything you never wanted to know about painful periods..

Adenomyosis
• Symptoms include very heavy bleeding and severe cramps
• Is aggravated by the cyclical pattern, so the key is to stop the menstrual cycle
• Occurs mostly in women over 35, many who have undergone uterine surgery, e.g. fibroid removal or Caesarian
• There is no known cause
• The condition worsens with age, but tends to right itself after menopause

One in ten women suffer unbearably painful periods, have to miss work, cancel holidays and even become housebound for several days every month. The cause of this could be adenomyosis, a condition of the uterus that most women have never heard of.

With adenomyosis, the tissue that lines the uterus (the endometrium) grows into the muscle of the uterus. This means that the blood and endometrial cells that usually leave the uterus with a period every month are trapped deep within the muscle, causing severe cramping and very heavy bleeding.

This condition tends to right itself after the menopause, but those who suffer from it find that the knife-like cramps and heavy bleeding worsen as they get older, and many women become anaemic through loss of blood.

The symptoms include:-

- very heavy and prolonged bleeding that can include passing blood clots;
- severe cramping during menstruation that increases with age;
- bleeding in between periods;
- painful intercourse;
- if the condition is advanced, it can cause infertility.

However, these signs can be similar to those suffering endometriosis or fibroids, so careful examination is necessary to detect the exact nature of the condition.

“There is little awareness of adenomyosis because, as it is located within the muscle layer, it is difficult to diagnose,” says Dr Sarah Gray, GP Specialist in Women’s Health. “The symptoms are pain associated with the onset of bleeding, so I can pick it up from a pattern of symptoms. If all other tests come back negative, I assume the problem is adenomyosis.”

The statistics are sparse, because the problem has, until fairly recently, only been diagnosed by examining the tissues of women who have had a hysterectomy. Approximately 10% have been found to have adenomyosis, but it is believed to be present in about 5% of all women of a fertile age, and many of these are unaware that they have the condition. It has been found that 12% of women with this disease have also had endometriosis.

Diagnosis can be by means of a vaginal examination which often shows a tender and/or enlarged uterus. Now MRI scans and ultrasound are used by clinical professionals to detect the condition, but none of these definitely prove that adenomyosis is present. The only accurate diagnostic method is still after hysterectomy.

While some GPs believe that hysterectomy is the best way to treat adenomyosis, most women prefer not to have such invasive surgery. For women who have had children or do not wish to conceive, the Mirena coil has proved extremely effective. This intrauterine device works by releasing the hormone progestogen directly into the uterus. This thins the uterus lining, so there will be less, or no, bleeding every month.

“The Mirena coil is 94% effective,’ said Una Stevens, a nurse for the charity Woman’s Health Concern, “but obviously it doesn’t suit everyone. For the first few months following insertion, heavy bleeding can occur, but this can be counterbalanced by taking a progesterone tablet such as Noresthisterone, which will settle the uterus and reduce blood loss.”

Other pharmaceutical treatments include a type of hormonal contraceptive commonly known as the 'mini pill' or progestogen-only pill (POP). It contains the active ingredient desogestrel, which is a synthetic progestogen, similar to the natural progestogens produced by the body. This breaks the hormonal cycle, thereby eliminating any bleeding and cramps.

Gonadoptrophin releasing hormone (GnRH) treatments lower the levels of oestrogen in the body which lightens periods and therefore reduces symptoms, and can reduce the degree of the adenomyosis. However, these treatments cannot be taken for long without a break, and can have adverse side effects such as headaches, depression and weight gain.

“For patients wishing to conceive, I would suppress the cycle until they did want to get pregnant,” says Dr Gray. “That means taking the contraceptive pill continuously – without a gap. Adenomyosis is aggravated by anything cyclical, so the key is stopping the cycle.”

Some male GPs can be dismissive about painful or heavy periods, meaning that many women think nothing can be done, so it important that nurses have a knowledge and understanding of this condition.

“It’s all to do with pattern recognition,” says Dr Gray. “Maybe some GPs don’t listen hard enough and don’t pick up the problem.”

So if you have been having very heavy or painful periods, it is important to keep a record of your periods over the last six months and go to your GP. In addition, Women’s Health Concern (details below) have a team of medical experts available to give advice on gynaecological and menopausal matters.

“Adenomyosis seems to have been put on the back burner,” said Una Stevens. “Fibroids are identified, and endometriosis, but we haven’t had any calls about adenomyosis on our helpline. People don’t seem to know what it is, which is strange. It needs to be highlighted.”

Many women suffer unknowingly from adenomyosis every month. With more information and wider recognition of the condition, periods needn’t ruin your life.



Both Dr Sarah Gray and Una Stevens are associated with Women’s Health Concern
Whitehall House
41 Whitehall
LONDON SW1A 2BY
www.womens-health-concern.org
General Enquiries info@womens-health-concern.org
020 7451 1377
Helpline 0845 123 2319 local rate call Mon-Fri 10am – 1pm

British Menopause Society
The-bms.org

Nursing Standard, 6th February 2008

Awards and Twins

I have been awarded the E for excellent award from Debio and now from Akelamalu as well.

Many thanks, you two. I am delighted by this award, and glowing to start a Monday morning. What a boost! But rather than pass it on to five specific people, I think you all deserve it. Please collect and display as you see fit. Or not.

And to continue my story of the tenants, which keeps being interrupted – the next lot were twins who said they were eighteen. I thought, No Way are we having eighteen year olds living upstairs. The place will be a tip, they’ll have endless parties, it’ll be unbearable. (I hadn’t run the student accommodation office at Falmouth art college for nothing. I could tell you stories that would make you weep.)

But faced with the prospect of 18 year old twins, Himself’s eyes lit up, as you can imagine.

In fact the girls came to see the flat with their grandparents and Himself knew the grandfather from sailing days. “I’ll vouch for the girls,” said the grandmother. “If there’s any problem, I’ll sort them out. And don’t worry about the rent. I’ll pay that.”
So we eventually decided in favour of the girls. Or rather, Himself spent hours persuading me until I gave in.

In fact they were great tenants. Their mother had died several years before and the grandmother had brought them up, and done a very good job. They were polite, didn’t play music too loud (or if they did, they were extremely apologetic and turned it down at once) and being at college and then working at Macdonalds, they were out all day.

There was only one incident when they woke us up and that was one summer evening. We’d gone to bed early and I woke with a start, hearing whispering outside our bedroom window. (This was before Mollie, of course, or she would have barked the place down.)

I froze. All senses on alert, I lay there, my pulse banging in my ears. There was a burglar outside. They were about to break the window – murder us in our beds. What should I do? No phone by the bed – should I sneak out and ring the police from next door?

Then a knock on the window. More whispering.

As Himself was out for the count, I crept out of bed and tiptoed to the window, convinced I was taking my last breaths but would die a true heroic death.

I flung back the curtain – and there was one of the twins with her boyfriend.

“I’m really sorry,” she hissed. “But I’ve locked myself out and my sister’s away for the weekend.”

I wasn’t sure whether to laugh or cry. But all things considered, they were great tenants. They’re attractive, intelligent and caring girls and their mum would be proud of them.

A Very Special Man

Yesterday I was talking to a baker who provides the bread and other goodies at our Farmer’s Market. It turns out he’s been married to the same woman for nearly forty years and he has twelve children, all of whom help with the business.

What struck me was not only how in love he still is with his wife, but how close they are as a family. They never have big disagreements, which he puts down in part to not having had any TV in the house since 1990.

The kids all play together on the farm, riding, helping out (they earn their pocket money by washing the vans and helping clean trays) and every Sunday nearly all of them gather for Sunday lunch, cooked by the baker himself. There are 27 of them in total.

They’ve always worked for themselves, either running a guesthouse, a farm, a baby equipment business (from all those kids) and latterly the bakery. They mill their own flour and the whole family help with the baking, even those at school.

“We share everything,” he said “The family is our life. What could be better than working with those you love?”

When the conversation was over I felt privileged and humbled. What an incredible man. And what an amazing family.