Thursday, January 27, 2011

Who Controls Your Birth Control?

Originally published in the Montreal Gazette on January 18, 2011.



If you're reading this and you know my Greek mother-in-law, please don't translate.


I still use birth control.


We'll save the reasons why for another time. The point is, I don't want babies right now. I also don't want to be on the pill. I never liked the idea of putting hormones into my body that aren't supposed to be there, or tricking it into doing things it doesn't do naturally. After trying it for the second time and seeing how quickly my emotions rebelled, I went to my doctor and got fitted for a diaphragm. And that was the end of that story.


Until a year later, when I tried to renew my prescription. That's when I was told:


They don't make diaphragms anymore.


It was the strangest feeling. Living in this country, and growing up with a sex ed curriculum that included the diaphragm, I simply took for granted that whichever form I chose to use would be available to me. My doctor did point out that I was his only patient who still used a diaphragm - I think the word "granola" might have jokingly come up - but he also called it the "healthiest form of birth control" for the reasons I've already stated. So he made a few calls, and it was confirmed: Janssen-Ortho had stopped manufacturing the diaphragm, due, they claimed, to lack of demand.


I understand that the lowly diaphragm isn't as popular as the pill. It's more complicated and, unless used perfectly, not as reliable. (If used perfectly, the failure rate of a diaphragm is four to eight per cent, whereas the failure rate for hormonal methods runs between 0.1 and 0.3 per cent.) But surely there were other women with the same concerns as me? What about those who couldn't take hormones for medical reasons? And where does lack of demand figure in when things like tanning oil and TaB are still on the shelves?


I did some research and found a U.K. company called Westons that sold the Ortho diaphragm online. It cost $25 including shipping -about half of what I'd paid for my first one -and all was once again well until this year, when I learned that Westons had stopped carrying the Ortho diaphragm, too.


Desperate, I called one of the larger Pharmaprix in Montreal.


"I'm looking for a diaphragm," I said.


"How do you spell that?" the pharmacist asked. "Does that come in pill form?"


I called a Jean Coutu, who told me they could order a brand of diaphragm called the Cooper Surgical Milex for $98 plus taxes. I asked if that included spermicide, which my last pharmacy diaphragm had. No, the pharmacist told me. Spermicide is no longer available.


I found a Yahoo group for women who use, or are considering using, barrier methods of birth control, and when I mentioned I wanted to write this article, dozens of stories flooded in. One American woman was told by her doctor that cervical caps - which work similarly to the diaphragm and are available for purchase online - are illegal in the U.S. A woman in Australia had to order spermicide from Canada. One woman in Ontario was completely unable to obtain a diaphragm from Shoppers Drug Mart, and another had such difficulty getting either a diaphragm or cervical cap that she's resorted to using the rhythm method and withdrawal combined with condoms on her fertile days.

"I'd probably be ridiculed by health-care professionals," she says, "but I feel more comfortable taking the risk of possibly needing an abortion than injecting my body with hormones that make me act like a completely different person and whose long-term side effects nobody can say for sure."


That may be an extreme example, but it still points to a very large problem: An important and long-standing form of birth control may be in the process of going extinct. And lack of demand can very easily feed itself. Could it be a vicious circle? If the pharma companies no longer sell something, won't that lead sex educators to stop including it in their curriculum?


I asked Amanda Unruh, a member of the Sexual Health Network of Quebec who also runs the Shag Shop at McGill, if the diaphragm is still part of the sex ed curriculum in this province.


"On a basic level, yes," Unruh said.  "But whether teachers impart that basic information to students is another story."


Dara Maker, a family physician at Women's College Hospital in Toronto who works at the Bay Centre for Birth Control, talked to me about what's going on in Ontario.


"Young people are being taught about the diaphragm," Maker said, "but a lot of reason for lack of demand is it's not being advertised, and there's less people talking about it. Young women will talk about contraception with friends, and if you have less users, you have less women generally sharing information. In that way, it is a vicious circle."


Both agreed that the demand being down probably has a lot to do with more hormonal methods coming on the market in the last 10 years, which are more efficient and "safer"-at least when it comes to failure rates. And the Shag Shop started selling the Cooper Surgical Milex in November, for $60. The shop is located in the McGill health clinic, where doctors are available to do fittings.


Had there been much interest in the diaphragm?


"We do get a lot of people asking about hormonal contraceptives but saying they're not comfortable," says Unruh, "or younger women who have been on a hormonal method and it hasn't been for them. Most people go to the hormonal method first because that seems to be the social norm. But people are asking more and more about the diaphragm and the female condom. I think it'll balance out over time."


By the time I found out about the Shag Shop, I'd already learned, through the Yahoo group, that another brand still available through Westons fit the same way as the now defunct Ortho diaphragm. Spermicide is available through a site called Ladytobaby.com, which also retails cervical caps.


Let's hope that these companies continue to offer alternatives to hormonal birth control. Because as much as I love my mother-in-law, I also love my right to choose what goes into my body. And that's a right the drug companies shouldn't have.


The McGill Shag Shop is located in Suite 3300 in the Brown Building, 3600 McTavish St. 
Or call them at 514-398-2087. They sell spermicide, too.


Ladytobaby.com sells cervical caps, a natural (Nonoxynol-9 free) spermicide, and fertility and ovulation monitors.


Westons.com sells the Reflexions flat spring diaphragm for about $15, plus shipping. You'll have to get fitted by your doctor before ordering.


For information and discussion about diaphragms and cervical caps, go to http://groups.yahoo.com/group/DiaphragmsAndCaps.

Thursday, January 13, 2011

Fairy Godmothers

Originally published in the Montreal Gazette on January 3, 2011.


One of my fantasies has come true. No, it didn't involve leather or Javier Bardem, or revenge against the ex-boyfriend who dumped me for his first cousin. My fantasy was to have a fairy godmother.


Yes, like Cinderella. But not because I want glass footwear or a powder blue ball gown with puffed sleeves, though I wouldn't say no to either. Actually, I think everyone's entitled to a fairy godparent. It should be our birthright, and that's not as far-fetched as it sounds. Your Fairy G doesn't have to actually believe in God, or religion, or even be alive. They just have to provide guidance, encouragement and unconditional acceptance, without charging you $120 an hour.


Let me explain.


There's a voice inside my head. This voice spends most of my waking hours, and some sleeping ones, emitting a loop of impossible and usually contradictory demands. Wake up/You didn't get enough sleep. Don't eat carbs/You didn't eat enough carbs and now look, it's 11:00 and you're hungry. You didn't work enough/You don't get enough down time. You haven't become who you're supposed to be/solved the world's hunger crisis/fixed the BP oil spill. You, Natalie Karneef, have failed.


The voice happens to sound exactly like my Hungarian mother, but that's another story.
In fact, J.K. Rowling once said that once you're old enough to drive a car, you're old enough to stop blaming your parents, and I agree. I know I'm the one who keeps my Head Mother (also known as the Hungarian Horntail, in homage to one of J.K.'s more aptly named magical creatures) alive and well. I listen to her. I feed her goulash. I believe her when she tells me that I've managed to live my life 100 per cent incorrectly, from my socks to the state of my bank account. I continue to strive for her unattainable balance between too much and too little -a line so thin you'd have to be superhuman to even see it, at which point she'd accuse you of needing glasses. Or, at least, I used to strive for it.


In the last little while, for reasons I can't quite understand, I've tried to stop. I've begun to acknowledge that the Horntail's voice is not some omnipotent, irrefutable Truth. Baby Horntails have since popped up to remind me how badly I'm doing at it, but I do my best. Yes, I'm even hard on myself about not being hard on myself. Perhaps now you see why I needed that Fairy Godmother.


I met Barb at a yoga workshop she taught almost 10 years ago, and was both drawn to and slightly thrown by her. My mother also took the workshop - yoga, incidentally, is one of the Horntail's secret weapons to make sure I'm aware of how inflexible, unhealthy and spiritually un-evolved I am -and she and Barb got into a conversation about their children. I don't remember what was said, exactly, until Barb beamed at me and exclaimed, "Aren't our kids AMAZING?"


It felt like the sky had opened, and a ray of sun was shining directly down on my head. Amazing? Me? I'd never heard anyone talk about their children in such a way. Now, a decade later, I understand that somewhere deep in her heart, my mother might - possibly - think I'm amazing, and that her upbringing and genetic makeup doesn't permit her to say so out loud. But at that moment, I wanted to know this Barb. I wanted to take her home, or, better yet, move into her basement. Instead, I wrote her an email.

We corresponded over the next few years. Nothing heavy, usually: just questions about yoga from me and little notes of encouragement from her. I didn't tell her I'd taped a photo of the two of us to my mirror, or that, when things got tough, I imagined her reminding me to breath, like she did in the workshops. Until I got engaged.


I had figured that preparing to get married would be like living in a giant snow globe, with cupcakes, rose petals and lacy things fluttering around at all times. That I'd float through dress stores while Tony and I gazed together down the yellow brick road of bliss and happiness. Instead, we were fighting like wild dogs. And I could hear the Hungarian Horntail saying it, again and again: "You can't even be engaged properly. This is all your fault."


I didn't actually talk about this with anyone, of course. God forbid I admit that I was anything but over the moon about spending the rest of my life with another human being. No one would want to know, I decided, and by speaking my fears out loud, I figured I was was professing to some kind of failure. I was supposed to be happy. We weren't supposed to be
at each other's throats like guests on the Jerry Springer Show. I was convinced the rest of my married friends were barely able to keep their hands off each other except to hang framed photos of their weddings. I couldn't shame myself by admitting how terrified and confused I was. So, I wrote Barb.


I hoped that, with 40-odd years of marriage behind her, she might understand how far Tony and I were from premarital bliss. So I poured my heart out, and then threw in, very casually, right at the end, that I hoped she didn't mind that I sort of thought of her as my Fairy Godmother.


I didn't hear from her for a week. Then two weeks. And just when I'd convinced myself that Barb was trying to come up with a kind way of breaking it to me that perhaps I might look into paying someone $120 to listen to me whine, or worse, that I should just throw in the towel and stop trying to fool myself that I could be in anything resembling a relationship, she finally wrote, apologizing profusely for her computer being down. Then she said the most incredible thing: that it was good -healthy, even -to be questioning getting married. She told me about her own relationship, and all the doubts she'd had over the last 40-plus years. Also, she asked, where were these questions coming from? Could they possibly stem from some archaic belief system I'd strung together from Hollywood and Martha Stewart Weddings? Were they "voices," whose only purpose was to make me feel bad about not measuring up?

Yes, I thought. I know a little something about voices.


Barb said that the most important thing was to trust what I knew deep down, but that it was always wise to seek advice from those with more life experience.


"Please write me anytime and ask me anything you want," she said. Then she signed off "Your Fairy Godmother."


That email was three years ago, but I still go back to it when things get sticky. Especially because, in 2009, Barb began a too-long and too-short battle with Lou Gehrig's disease. I tried to support her as much as I could, but the truth was, Barb faced illness and death with more grace and wisdom than I've ever had facing life. She passed away this August.


As I'm sure you've guessed by now, Barb is still my Fairy Godmother. Even more so, actually, as she no longer has to obey the laws of physics. She can show up whenever she feels like it, and even by broomstick. In a small book you might have heard of called Eat Pray Love, Elizabeth Gilbert prays to God from her bathroom floor. God tells her, simply, to go to bed, and that's not far from Barb's brand of advice. When life seems ridden with potholes and failure and fear, she tells me to go for a walk. When I'm in full, throat-closing-up panic, she reminds me that I am not clairvoyant and that tearing my hair out about what I'm afraid will happen next week or next year is the biggest waste of energy there is. When the Hungarian Horntail is snarling and vengeful and punishing, Barb is gentle and loving and kind. Go ahead and call the men in white coats, but I feel saner now than I ever have before.


So give it a shot. Really. It can be Oprah or your next-door neighbour or a long-dead relative or Jesus. Just hand them a wand and ask them to do the honours. They will say yes. That's why you chose them. And you'll be amazed at what they'll do next.

Tuesday, January 4, 2011

Sing Out


Originally published in the Montreal Gazette on December 28, 2010.

A couple of months ago, my brother, who is 6 years younger than me, invited me to  see his band play. 

“It would mean a lot,” he said, and as his definition of family time usually amounts to a text message once a week, I promised I would come.

The show was at an art gallery in Little Italy, and when I arrived, my brother, or Phoof, as we nicknamed him when he was too young to protest, set me up in the back with the sound equipment.  This was fine by me, as it saved me from having to mingle with the young folk.  I sat there watching girls in plastic hair bows and guys in heart-shaped sunglasses scuttle by, feeling the usual discomfort-veiled-as-judgment I usually experience when I’m amongst my brother’s generation. 

Then I remembered something: I’m taking singing lessons.

I’m not sure why, but I feel embarrassed admitting this.  I’ve wanted to sing since God knows when – okay, since I was five and saw Dorothy singing “Somewhere Over the Rainbow” in The Wizard of Oz – but once it became clear that opening my mouth and having sounds come out of it was not a skill that was going to come naturally, I wrote it off.  Even after a professional singer told me that your voice was something you could develop with lessons, I gave my  usual list of excuses: lack of time, lack of money, lack of reason.  I think that if something doesn’t serve our careers, our images, or our ability to escape a lack of success in either of these arenas, after a certain point a lot of us figure, “Why bother”? 

Then, early this year, I heard an all-female choir perform and I knew: I needed sing.  It was as if a voice spoke to me from on high, and so, with less time and disposable income than I’ve ever had, I started taking lessons.  And I found out, it’s true: even the warbly-throated among us can learn to sing.   I come out of every lesson so happy it feels possible that I might take flight. 

I auditioned for the choir. 

I didn’t get in.

It’s funny, isn’t it? You spend a lifetime telling yourself something isn’t important to you, and when suddenly you can’t do it, you feel as though you’ve been robbed.  I spent days moping and sniffling and feeling fabulously sorry for myself, and telling myself I might as well not bother with anything, including eating or personal hygiene.  I would never sing again, I decided.  It was time to admit that this was something at which I, officially, sucked.

Then, I went to my brother’s show.  And looking around that art gallery that night, I realized that these were people who hadn’t given up.  They still take the time create things, even if those things don’t benefit their hiring prospects.  They’re still full of hope and possibility and conviction that they will change the world, while I was sitting there worrying about how I was going to catch up on my sleep schedule.  Plus, how many so-called “adults” passed me when I was their age, strolling along with my fuchsia hair and platform sneakers and fun fur shoulder bag, and thought to themselves, “What the hell was that?” 

Then my brother appeared next to me and began taking off his pants.

I forced myself to smile encouragingly as he removed his shirt and wrapped a sarong around his waist, then strapped a conga drum to his chest.   A crowd started to form around the stage, so, screwing up my courage, I left my post and joined them, trying to assume the kind of facial expression that said, “I come to these sorts of things all the time.”  A pounding started echoing through the room, and I realized it was coming from Phoof and another, similarly-attired boy.  It created this amazing kind of tribal, surround-sound effect, and the crowd parted so the drummers could make their way to the stage. 

Suddenly, I found myself about to explode with pride – a big sister, holding-back-tears kind of pride.  My parents and I constantly worry about my brother.  We nag him about partying too much, about not making enough money and abusing too many substances, about staying “on track” and being more “focused” and not being “responsible”.  And there he was, rocking a crowd, doing what so many of us dream of doing but never will.  Watching him, I wondered: when did I become so judgmental, and so afraid?  When do some of us, pardon the expression, grow up?  When do we lose – again, forgive me –  that inner child, who makes us create and keep creating, even if we “suck”?  And why on God’s green earth do some people get to bomb their way through that fear, while others shut down and stow it away, only letting it out at late-night dinner parties after too much whiskey?

I went home that night and wrote my brother an e-mail, and made him promise me that he’d never give up playing music.  And after that, while I harbour no fantasies about joining him on stage, I realized I had to practice what I preached.  So I signed up for more singing lessons, and formed a little group of my own.  We sing in my basement: a bunch of 30-somethings like me, who just want to make music for the sake of it. 

And just recently, my brother had another show.  The crowd was about five times bigger than the last one, and there was even, to my delight, body-surfing.  And in the middle of a song, my brother yelled into the microphone, “My sister’s here tonight!” 

I was almost dancing too hard to hard to hear him.

Saturday, January 1, 2011

Anybody Out There, Their or They're?





This story originally appeared in the Montreal Gazette, December 24th, 2010.


My friend Aly and I were at a party at a hotel bar the other night when in he walked: the last person I wanted to see.


Unfortunately, he was the only person Aly wanted to see.


We'll call him Javier, not because he bears any resemblance to man-God Javier Bardem, but because he hails from the same general region of the world, and is tall, charming and somewhat handsome. He's also Jewish, and so is Aly. She's in her early 30s, too. If you are in, or ever have belonged to, this demographic, I probably don't need to say more. Otherwise, I'll just recall a conversation Aly had with a Jewish matchmaker some months ago:


"If you're looking for a guy between 35 and 40 in Montreal," the matchmaker said, "you can forget about it."


But Aly didn't forget about it. She's like the Spartacus of dating. She receives messages from guys on Plenty of Fish with lines like: "I'd love to massage your feet over dinner," but still she goes forth. One guy sent her his entire life story, beginning with his family history in the 1930s. He even told her how he met his first wife, and how he took the "until death do us part" bit very seriously.


Obviously.


Some of the messages were so awful that Aly finally changed her profile to read: "I'm looking for a guy who knows the difference between There, Their and They're."


The first guy who responded got only two out of three right. But he was Jewish, so Aly had dinner with him, anyway.


Then, she met Javier. They went on a few dates, which, according to Aly, were steeped in the kind of chemistry you only read about in paperbacks at airport gift shops. But Javier didn't feel the same way, and soon he informed Aly that their relationship had "reached a plateau." Still, Aly kept seeing him. She said she hoped he'd get to know her better and change his mind.
I'd recite lines from He's Just Not That Into You, and she'd talk about chemistry. I'd go on tirades about self-worth, and she'd say: "I know" 20 or 30 times and then go out with him that evening.


"Tell him to take his plateau and shove it," I begged her.


And sure enough, one day, Javier disappeared.


Aly dated on. She tried to forget Javier, or at least, she told me she tried to forget Javier. And then, that night at the hotel bar, the most incredible thing happened:


Aly met a single Jewish man between 35 and 40.


He was tall. He was handsome, in a Clark Kent kind of way. He wasn't pretentious, but knew about art.


"We have to DO something!" hissed a friend, suddenly aware of the beshertness of the situation.


In minutes, we'd engineered a plan to continue on for dinner at a restaurant down the street that served $18 glasses of wine. But, as we were putting on our coats, Javier showed up.


"Oh my God!" Aly squealed, and threw her arms around him.


Of course, he joined us for dinner, and, of course, he sat next to Aly, while Clark Kent took a spot at the far end of the table. Still, I managed not to asphyxiate him with his tie, and Aly drank four glasses of wine, which does for her what a magnum of vodka chased by a keg would do for most people.

As we finished our meals, I announced that I was driving her home.

"Oh, Javier," she mooned, as soon as we were in the car.

"Yeah!" I said. "So how about Clark Kent?"

"I haven't stopped thinking about him this whole time," she went on, clearly not in answer to my question.

"But why? He doesn't appreciate you! He's not worth it! And by giving him your company, you're allowing him not to respect you!"

"Isn't he yummy?" Aly said.

I took a deep breath, ready to leap onto my soapbox with renewed vigour, but we'd already arrived at her apartment. Looking up at her window, it occurred on me that I was about to turn around and drive home to someone waiting for me in a warm bed. I have what Aly wants -despite my attempts to convince her otherwise.  It's far from perfect, but it's so easy for me to forget what life was like before. Who am I to give dating advice? How many times did my friends shake their heads while I spouted lines about chemistry? I'd listen to them, then continue to swoon over a guy who didn't deserve the lint from my hairbrush, much less my affections. And when I finally did see the light, ended things and returned the offending guy's CDs, it wasn't because of anything they said. It was because of a realization I came to on my own.

"Okay," I said. "Do what you have to do. Just please, don't let him hurt you again."

"I won't!" Aly sang, and fell over the curb on her way out of the car.

I'm still hoping she'll give Clark Kent a shot.  But while I have your attention, do you know of any single Jewish guys in Montreal between 35 and 40?