Hello everybody and welcome to another episode of Vet Chat. Today we are very excited to be joined by Doctor Chloe Hannigan, who will be sharing his thoughts and helping us to raise awareness ahead of endometriosis Awareness Week in March. Chloe qualified from the RVC in 2012 and currently works as a locum small animal vet and a registered yoga Alliance professionals yoga mediation teacher.
She founded Vet Yogi in 2017 to improve the physical, mental and emotional well-being of the veterinary profession. Through vet yogi, Chloe provides tailored yoga and meditation classes, workshops and speaks at conferences for veterinary individuals, practises and groups. She is passionate about providing wellness tools for the whole veterinary team and teaches many various styles of yoga.
Vet Yogi also offers a selection of yoga props, clothing and accessories, and home fragrance gifts, all designed to help busy working professionals create a sanctuary of calm in their own space. To find out more, please do visit www.yogi.com.
So welcome, Chloe, thanks so much for joining me today. You're very welcome. Thank you for having me.
So this is our 2nd endometriosis podcast. So our first was with Alex Taylor, the BDNA president, who shared her endo journey with us several months ago, and our community gave us such great feedback that we really wanted to keep the conversations going. So thank you for enabling us to do that.
I thought just to sort of set the scene, we could go over some facts and figures around endometriosis for people who may not be aware of the condition. So endometriosis is an inflammatory condition where the tissue, similar to the lining of the uterus grows outside of the uterus. It's a chronic disease which can be very difficult to diagnose, and it provides a wide and varied range of symptoms.
There is no cure, but there are effective treatments which can be used. 1 in 10 women have endometriosis during their reproductive years, but it can take anywhere between 4 and 11 years for women to receive the correct diagnosis. And the fact that shocked me most was that 6 out of every 10.
10 cases of endometriosis may remain undiagnosed. So Chloe, would you start please just by telling us a little bit about your story and when you first suspected that you, you know, had endometriosis or something that didn't quite feel normal. Yeah, of course.
So I think, if I may, I'll just start by actually picking up on your last stat there that, you know, so many women can go, without a definitive diagnosis, with endometriosis, because I'm always very upfront to say that, I actually still do not have a definitive diagnosis. Mine is more a diagnosis through exclusion, of other tests that I've had. So, I think, the fact that there are so many women out there, Who are potentially struggling with a a huge variety of symptoms without a diagnosis can also add to the level of sort of anxiety and stress around the condition.
So for me, I think, you know, right at the start, I mean, I started my periods when I was, 12. And for a couple of years prior to starting my periods, I would have very regular monthly, what we thought of as stomach pain from being about 10 years old. And it was only really when I did then start, and, you know, Made the connection that there was probably things going on even before my period even officially started with the regularity of the, the discomfort.
And obviously then when I'd experienced what period of pain truly felt like, I could make the connection in my head that I'd been experiencing kind of a milder version of it, even before my periods had physically started. . And then they'd always, you know, always been extremely painful.
I remember, you know, going through secondary school. It can, it affected my ability to concentrate at school. It affected my ability to engage in the sports that I loved, sometimes.
There's such a huge variety of symptoms. I mean, for me, definitely, day one and day two of my, period are extremely uncomfortable. And I've learned over the years, various ways to manage that pain, but also just other symptoms like back pain, headaches.
I mean, the days leading up to it, incredibly, like, sensitive breasts and, just feeling wildly hormonal, as well. Because I think it's easy to concentrate on the physical symptoms, but often the emotional symptoms equally as troublesome if you haven't learned to, to manage them effectively. So all through my teens, to be honest with you, You know, I had experienced, really painful, often debilitating periods, sometimes with nausea, sometimes with diarrhoea, which is also pretty common.
Bloating. I remember even a couple of times when I was around 1516. I had, periods where I, I would faint on day one, from the pain and just from, also, if you're vomiting and you feel nauseous, you can't keep painkillers down.
So that can sometimes be a bit of a problem as well. So yeah, it's been, it's been quite a long time, really. I think right from the get-go.
I suppose, the other thing with it is You know, when you're a teenager or you first start your periods, everyone tells you, you know, to wait a little while before they kind of regulate, . And I think people who experience things like endometriosis or any kind of reproductive, abnormality like polycystic ovary syndrome, whatever it is, it can take quite a long time for your periods to become regular if they actually do at all. So I'm, you know, also as a teenager, it would be pretty common, for my periods to be a couple of weeks late or just Suddenly appear out of nowhere.
And, that, that also, when you're going through, you know, getting used to having a period in the first place, then being at school, being very active and sporty, so, you know, have it just kind of pop up out of nowhere was, quite a lot to deal with as a, you know, self-conscious teenager. Absolutely. So yeah, it's kind of been a bit of a thing where I was quite lucky in that I had my mum who I could talk to about it because my mum also.
Really suffered as a teenager and as a younger, woman with very, very similar symptoms. So I always had her to kind of, you know, check in with, and her background as a nurse as well was very beneficial for kind of asking questions about, like, You know, what is normal, what is abnormal. Sorry, Chloe, I was just gonna say when you were younger, did you go to see a doctor or did you just kind of use your mum as somebody to kind of go to when you needed that support?
So to be honest with you, like, the, the advice when you're like in your sort of Well, for me, in my early to mid-teens, there wasn't really any mention of, like, diagnostics at that point. There was a lot of kind of being, you know, advised to be patient and wait for things to settle. And, you know, a lot of, advice geared towards maybe starting contraceptives that could help, lighten periods and alleviate pain in that way.
Which again, I think is pretty common, you know, that. That's sort of one of the go to's that they do for people experiencing heavy periods is they, they put them on to some form of contraception, to try and manage that. So there wasn't really a chat around kind of any diagnostics, until I kind of got to my late teens.
And, could start to advocate for myself a little bit more. And obviously, by that time, you'd already had a few years under your belt of, of say, you know, of saying we've waited and see, you know, we've been patient. Things still aren't right.
This can't be normal. Yeah. So yeah, when I was, I think I was 19 when I.
You know, as part of my, just general sexual health, was talking, to one of the nurses, and just saying I had to switch pills a couple of times as well, because they, you know, would help initially and then would stop helping with the pain and with the lightness and, . You know, that in itself was really surely an indicator that that's not something that you can just mask. So when I was 19, they advised for me to have a cervical, like a smear test.
I also had to have like STI tests and things, just basically they were trying to screen for a few things. So most women. In the UK anyway, won't have their first smear test until they're in, you know, in their 20s, like mid-20s.
I had one a bit earlier, which I suppose was the the starting point of diagnostics towards why you're having this increased abdominal pain. Mhm. But yeah, it's, so it does take quite a long time.
Yeah, to go through things. And I mean, at that point, I also have blood tests to check that, you know, cause when, when you have the gastrointestinal symptoms as well, like the vomiting and the diarrhoea alongside it, you know, rightly so, they look into things such as maybe like, are you celiac? Are you, do you have other, like, metabolic issues?
So, I think around at 19, I had the first sort of round of tests, I would say, where you had like pelvic exam. Cervical screening, STI screening, blood tests, and things like that, but it certainly was not the end of the testing. Yeah.
No, absolutely. I think, I mean, it sounds, you know, so, so tough, and obviously, you touched upon your hormones and, you know, hormones have a hand, don't they in almost everything that goes on in our bodies and, you know, they affect our brains, our emotions, so. I guess with endometriosis it sounds like it's been, you know, so tough mentally, not just physically on your body.
Yeah, it can be really tiring. And I think the relentlessness of it, like, you know, every month for decades of your life is, that's a marathon. So learning to kind of regulate yourself, not just, you know, your pain, but also developing the self-awareness, I think, around your cycle of, you know, where you may have days that you're going to be particularly sensitive, perhaps, or, you have days where you need to be really mindful of how you interact with people, because you're just trying to deal with what's going on in your body and don't always maybe have the patience or the reserves that you would have on another week.
So it can be, it can be pretty draining, I think, you know, in terms of like the hormonal swings and things, feeling unreason, I say unreasonably, as, as in, you know, all, all emotions are valid and reasonable, but. Reacting more to things than you usually would if you were in a normal frame of mind, and particularly in a job like veterinary, where we're constantly dealing with grief, demanding clients, difficult cases. You know, there are certain days of the month.
Where you just have to be really mindful that what's happening to you isn't you. So that when you start, when your doubts start to creep in or your confidence takes a hit or you, you are feeling more frustrated than normal or, more sensitive to, sad cases or difficult clients, it, it's very exhausting to have to perform that level of self-regulation on such a regular basis for something that's out of your control. Yeah, absolutely.
Do, do you feel like it has had quite a big impact on your professional, you know, working life as a vet? Well, certainly, you know, when I first qualified, I was doing mixed practise, and I'm only 5'3. So that's always a, that's a challenge already, where you feel like you have to, you know, turn up on farm or stables and kind of have a sort of prove yourself mentality already, because you're not necessarily what the clients are expecting.
And then when you factor in that you may be experiencing quite debilitating pain that day, that you're only keeping at bay with, like, a cocktail of, of painkillers. And also, You know, moving around in mixed practise, just the, just the consideration of, of having an available loo, to obviously, take care of yourself, during your period, the practicalities of that, . That's another factor.
I think even in small animal practise, we all have those crazy busy days where, you know, you seem like you're hardly having the time to even pop to the loo, and it's such a basic need, that it can, it can sort of, play havoc with your day a little bit. But what I found to be, quite helpful. As I kind of, you know, got a bit older, more experienced with, with how it feels in my body is, having like a tracking app.
Where you can put in your data of your, you know, how, what symptoms you're experiencing that day. You can track your period, you can have a look back and see if things are sort of stabilising a bit or whatever. And to be honest, now that I am a locum, and I've been a locum for quite a long time, and obviously running vet yogi as well alongside that.
There are times where, when I'm talking about what locum days I'm available, I will deliberately avoid the days that I think are most likely to be days 1 and 2 of my period, because it's just not worth having to go in and do a 1011 hour shift, when you're in that much pain. And that's a privilege that I have as someone in charge of my own diary. When I was a permanent employee, you, you know, you just kind of had to, to get on with it.
And I do think there is this sense of, almost like, you know, reproductive, pain amongst women. Not just really being viewed as something that we just need to get on with versus if I'd injured my back or, you know, I had a a vomiting, you know, GI bug. I think For some reason, they're viewed as more.
Acceptable reasons to not go into work. Whereas like bad period pain or what people think of it as, you know, it's not really something you talk about that much, although I have to say, like, I'm just so over it, like, over attaching any shame to it whatsoever. If I'm not OK and someone asks me.
You know, or says, you don't look right. Are you OK? And I just say, no, like, my uterus is absolutely obese in today.
Like, why shouldn't we? If I'd hurt my arm, I wouldn't have a problem saying that. If I had a headache, I wouldn't have a problem saying that.
So, especially amongst a group of, of clinicians where you can express your discomfort in terms of anatomy, I don't think there should be any embarrassment around having to say that you're really struggling because of that part of your body. Yeah, absolutely. The more we normalise these conversations, you know, the better it will all become.
And I think, is that, is that sort of the main piece of advice would you say that you would give to other women in the veterinary field who might be going through a similar situation or, you know, might be suffering a little bit in silence? Yes, I, I suppose my main piece of advice for anyone. With sort of anything like that would be advocate for yourself as you would advocate for one of your patients.
So whether that is to your doctor, whether that is to your employer or other healthcare professionals, whatever it is, don't suffer in silence. I know it's not the easiest thing to talk about, you know, if I'm honest, it's always nerve-wracking coming on a public forum like this and talking about something that is quite personal, but, The, as you said, the more we normalise these conversations, the more it's accepted as just being another part of the female anatomy, rather than this sort of weird taboo topic that should be like kept behind closed doors. .
It's, yeah, it's really just about advocating and, and particularly when it does come to seeking help from, medical professionals, you know, we're in such a unique position in our, industry, in the veterinary profession that we're clinically trained. We can have these conversations on a level with your GP or whoever it is you're talking to. So we already come in armed with far more information, in relation to anatomy, in relation to understanding normal physiology and abnormal physiology than the average member of the public.
So utilise that and, and put it to your kind of advantage because, as I said, when I was 19, that kind of started the road on the testing of, like, you know, the first bit of acceptance that These debilitating period, periods that I was experiencing were not normal and not acceptable. But I think it wasn't until I was in my mid-twenties and I actually had to, I had a, had a normal, cervical smear, results. I then had to have a biopsy.
I then had to have a procedure following that. And it was kind of a bit strange in that having had that, That then opened the doors to further diagnostics for the suspected endometriosis because It is kind of sad in a way that a a different condition almost validated the need for further tests, but it was like people. Took you a bit more seriously when they realised that you'd had to go through other reproductive diagnostics.
So, I think in my mid-twenties, I then had, you know, things like ultrasound scans, which is not a definitive, a definitive way to diagnose endometriosis, but does help rule out other things like fibroids or, you know, assess your ovaries, . So, it's been quite a long journey. So I, I did have a little wry smile to myself when you were saying it can take, you know, 4 to 11 years to be, diagnosed because, yeah, looking back from 19 to kind of mid to late 20s and still not having the definitive diagnosis, because, in fairness, I, I did decline the, slightly more invasive, Test the the definitive test to, to go and have a look with cameras, just because I felt that my management wouldn't change.
So whether, you know, whether I had that, and I'd spoken to other friends and colleagues who'd who'd had that procedure and really felt that it was quite a lot to go through for not a lot of difference. So I was fortunate enough that they were open with me and I could kind of choose to avoid that step. .
But yeah, it's, it's really just about. Not Not kind of, I don't want to use the word fobbed off, but in general we do have a problem in our society of of women's pain being downplayed. Or being seen as more acceptable, for some reason, just something that we have to deal with.
And hopefully things are starting to change, . But yeah, just speak up. That's what I'd say.
Speak up. Brilliant. That's great.
And obviously, we couldn't not mention yoga, having you on with us today. And, you're very well known to the vet world as, you know, vet yogi. Do you think that yoga has, helped you with pain relief over the years?
Hugely. Absolutely. And when I say yoga, you know, I'm always very keen when I'm talking.
In at conferences and things that when, when we talk about yoga in the Western world, most people think of it as just the sort of the physical movement part, the what we call the asanana part, which is just one limb of yoga as an overall practise. So not only does the movement part of yoga help, but also things like the meditation. Aspects, the breathwork, the panayama.
There's so many techniques available to us as students of yoga, that can really help with pain management, can help with emotional management, you know, the mental aspects of, of things as well. So I now have kind of Certain routines around that time of the month I would say where I completely changed the way that I would normally practise yoga. I'm definitely a lot kinder to myself now than I used to be when I was younger because honestly I did buy in.
As a, as a teenager, to this kind of idea of just having to push your way through it. Now I think I'm a lot kinder to myself when I'm in pain in general, and that's certainly been something that I've developed, over years on my yoga mat. Yeah, brilliant.
Are there any other tips or any other ways aside from the yoga that you know, you practise to sort of find relief with the pain? Yeah, so I think the main thing if, if people, you know, are new to yoga or they haven't tried it, would be remembering that there's so many different styles of yoga. So when I say I'm, I'm practising yoga, you know, depending on what day of my cycle I'm on.
So day one, I might still do yoga to help me regulate my pain, but it wouldn't be like a really hard, fast, cardio-based vinyasa flow class that I'd be doing. It would be a much gentler, slower hatha class or maybe a yin class or or even just some meditation that day. So.
You know, maybe doing a little bit of research into some of the different styles that that may help or fight, might, may help you at different times of, of your cycle, different times of your life stages, as well as you move through your kind of reproductive, life cycle. But as well as, you know, yoga and meditation, I think. For me, walking helps as well.
Getting out, I think, in the fresh air helps with so many things. And sometimes sitting still with the pain is just not comfortable. So a little bit of gentle, movement or just getting out and about, I'm lucky enough, to often live, near the beach.
So a bit of distraction as well, a bit of mental distraction. Obviously, painkillers, which I'm, I'm not going to go into because I think that's a discussion for people to have with their, their medical professionals as to what medication is right for them. But as I've said, they can have limitations really, because if you are experiencing the nausea symptoms that I get, quite frequently with the more severe, painful months, keeping painkillers down is, is a challenge in itself.
So I've, I've kind of learned not to rely. On them. Plus, if you are trying to function, obviously some painkillers, have, you know, the stronger painkillers are not necessarily safe to take if you're having to drive or you're having to do a very skilled job.
So, finding other things away from pain relief for me has been a bit of a revelation. I'm also a huge fan of just like, Hot water bottle, it's such a, it's such an oldie but a goodie, like just that little bit of like warmth and comfort, you know, and I think just approaching yourself. With kindness, which can be so challenging at a time when your brain may be taking you off in some horrible places, .
But trying to just You know, accept that. Perhaps on this day, you are not going to be your best self, so what can you do to help it to be a little bit more bearable. Yeah, yeah.
Absolutely. That's great advice. I think, as you say, it, it does purely just depend on what you feel like that day, doesn't it?
And just listening to your body and just being kind to yourself, you know, you might just want to sit there and have a hot water bottle and not move, or you might want to get out and get, you know, lots of lovely fresh air. I think it's just listening to what feels best for you at that time, isn't it? Absolutely.
And also, I think for me, as I've gotten a little bit more into my kind of holistic health, and the self-awareness around my cycle, around my, the way that my body sort of functions with it or reacts to things. Just, you know, also not necessarily expecting like, Every single period is gonna be the same either. Because I certainly have ones that are worse than others, maybe at times when I've been particularly stressed out or, I haven't been able to do as, as much of my kind of self-care practises in the lead up to it.
So trying to also just Be aware and just observe yourself without judgement as to how things go and notice any little triggers for you maybe that might increase your symptoms, . And seeing what you can do to mitigate those. Yeah, absolutely.
No, that's great advice, Chloe. Thank you so much. And we are unfortunately running out of time.
Is there any other final pieces of advice or anything that you'd like to share with our listeners? I suppose it would just be. Like Just knowing that there's nothing wrong with you, that just because Parts are causing you challenges or, you know, not necessarily, functioning as you would wish them to, to just, you know, wouldn't we all love it where, you know, your period came round and you, you didn't even know, and you just sailed through it for 3 days.
And then that was done. And like, off you go. Like, of course, of course, that would be a dream.
But, yeah, I think just Accepting that just because there may be something, I hesitate with the word wrong, but. Let's use it for the purpose of it. Just because there may be something wrong with a particular aspect of your cycle or your anatomy does not mean that there's anything wrong with you.
Yeah. Wonderful. Oh, that's great, Chloe.
Thank you again so much for joining me, to continue the conversation around endometriosis. I think your story will really resonate with so many of our listeners in the profession, and you shared lots of great tips there. So thank you.
So much. I really hope that everybody listening will get involved with supporting Endometriosis this week in March, and we'll really take the time to educate yourselves and others. And this podcast really is a great place to start.
So thank you again, Chloe, and thank you everybody for listening. Bye, bye.
