Best Health : 2020-11-01



STORIES FROM THE GAP best health besthealth­ OCTOBER NOVEMBER | pain is steadily denied, underestim­ated, undertreat­ed or ignored by medical practition­ers. A 2016 study in the U.S. found that half of the medical students and trainees interviewe­d supported the long-held idea that Black people have a higher pain tolerance than whites — a belief that dates back to slavery-era dehumaniza­tion of Black people working on plantation­s. Dr. Abo Akintan, a Black woman and family physician with the Albany Medical Clinic in Toronto, sees a need for more culturally competent care on a daily basis. She says many of her patients report that previous doctors were dismissive and that they, the patients, often felt they weren’t heard. She says her Black patients are often more comfortabl­e dealing with someone who is of their own race and understand­s their cultural context. “There’s that built-in trust that comes from seeing somebody who looks like you, and somebody who has a cultural understand­ing when someone says, ‘It just doesn’t feel right.’” A lack of trust in the health-care system, stemming from a history of racialized malpractic­e, has also long been brewing within many Black communitie­s across North America, Akintan says. Not enough support Eniola Hundeyin, a 33-year-old fashion and textile designer based in Toronto, realized the value of having Black practition­ers and personnel around when she went in for Lasik eye surgery earlier this year. Part way through the intense procedure, she remembers being cold — freezing, actually — in the operating room and “shaking like crazy.” Hundeyin had been told that patients who have the shakes would be offered Xanax, a fast-acting drug typically used to treat anxiety and panic disorders. But despite shaking so much that she was warned it could affect the procedure, she wasn’t offered the suffered from very heavy periods, and I thought that was the norm, because growing up in Jamaica, we didn’t talk openly about some of the ailments in our bodies,” she says. In her final year of university, at the age of 22, she collapsed while out with a friend during a particular­ly heavy cycle. She was then diagnosed with fibroids, the noncancero­us uterine growths that can often cause prolonged, heavy or painful periods, mild to severe pelvic pain, painful sex and possible fertility complicati­ons. Roughly one in four women will develop fibroids, but incidence rates in Black women are three times higher. The disease also tends to present at a younger age in Black women. Jacques says even with her diagnosis, she didn’t receive adequate care at first. She recalls that her family doctor at the time greatly underestim­ated her pain level and neglected to provide her with sufficient informatio­n about fibroids — even the simple fact that they can impact fertility down the road. “He didn’t ask me about my period, my menstrual health history, nothing,” she says. “He just gave me some pain meds and said, ‘I could put you on birth control,’ which a lot of women get pushed on, but it does not solve the issue. And that was the end of it.” Jacques, now the founder of Wombcare, a health and wellness agency dedicated to improving reproducti­ve health, says she continued to experience pelvic pain and heavy bleeding over the next several years. It wasn’t until a new physician and new gynecologi­st took her concerns seriously that she was able to get proper care, as well as a referral to a fibroid specialist. She was diagnosed with endometrio­sis in 2018 and when she finally underwent laparoscop­ic surgery that same year, doctors removed 38 fibroids from her uterus. One of the key issues reflected in Jacques’s story is that Black women’s medication once. A medical assistant, the only Black woman in the room, brought her a blanket. “She held my hand and gripped it tight, and just held me throughout the procedure, which calmed me down,” she says. “I really appreciate­d her looking out for me.” Later, the same assistant found Hundeyin a pair of protective goggles to take home, even though the other personnel said they had run out. Ann Marie Collymore, a copywriter and editor living in Toronto, also remembers being dismissed and ignored after giving birth to her first child. She recalls waking up in the hospital with her tongue hanging out of her mouth and slurring her words. “They were asking me my name, and I was giving them my phone number,” she says. She had started slipping into postpartum eclampsia. And when her mother, who has experience in the medical field, tried to get the attention of the attending doctor, she had little luck. “He was very nonchalant. [Meanwhile,] I’m still not making sense, I’m babbling, and he just walked out of the room,” she says. “So [my mother] followed him and said, ‘I need tests done for my daughter right away. This is not my daughter.’” Thanks to her mother’s advocacy, Collymore underwent a barrage of tests and was eventually diagnosed with HELLP syndrome, a life-threatenin­g condition marked by hemolysis, elevated liver enzyme levels and low platelet levels. “From what my doctor told me, there were times when they thought they were going to lose me completely because my numbers were just going lower and lower.” Now Collymore wonders what would have happened if her mother hadn’t been there to speak up for her. “With the pandemic, it scares the living daylights out of me, because [patients] can’t have anybody there, and anything can happen.”