RALEIGH, N.C. — For more than three years, I have been fighting the never-ending feeling that my body is failing me. It doesn’t look or function the way I would like it to. Extreme stress and unhappiness at work manifested as near-constant neck and shoulder pain. Leaving my job and career in February 2020, unrelated to the pandemic but a blessing in disguise, I started exercising more. Shortly after I came down with a particularly nasty case of plantar fasciitis and had to wear a boot for 3 weeks while we quarantined with 3 toddlers. I then got pregnant with my youngest which brought horrible nausea and sciatic pain that meant I could barely walk without physical therapy.
After my daughter was born, the sciatic pain and nausea immediately subsided but, when she was 5 months old, our whole family caught the absolutely miserable Delta variation of COVID19 and I, subsequently, also got long Covid. I exercised to the best of my ability and under the supervision of my cardiologist. My lung function was diminished and I now required an inhaler. I was able to, however slowly, return to exercise and my old self.
That is when I began experiencing pain in my left hip. That pain was a labral tear that required surgery. I am now 6 months past that surgery and making a very slow recovery. I still can’t return to my beloved group workouts, hiking with my family, or even just keeping up with the kids.
I have been in pain, of some form or another, for more than 3 years. All this is to drive the point home that my body cannot do what I want and need it to do. It is failing me.
Or is it?
I sat down with Dr. Elizabeth Sierakowski, MD, DABFM, DABOIM, the physician and owner of Essential Health in Raleigh. Trained in family medicine, integrative medicine, and functional medicine, knowledge, warmth, and empathy radiate from her person. We talked for over an hour, with her 2-month-old baby on her shoulder, and I am still reeling from that conversation. My number one takeaway is that it is not my body, but rather my proverbial village and the expectations of society that are failing us.
Where did we go wrong?
Dr. Sierakowski: Somewhere in very recent years [around the turn of the century], we have lost the culture where being a woman and doing and juggling and handling all the things that a woman handles including home and work and baby and body is suddenly unsupported and the expectation is that you do all of these things yourself. That’s new and that’s the problem because we don’t think of it as being new.
You can’t heal a body you hate.
Dr. Sierakowski: You as an individual are supposed to handle everything and get better by yourself and treat yourself kindly. Bounce back, or don’t bounce back and be ok with it but also handle that everyone around you is subtly making comments or you see them look at your body. It’s different and we can be kind all we want and that’s a lovely thing and I want that for people. That’s one of the mantras in my head right now – if my body looked and behaved this way for the rest of my life, would I hate it forever? I don’t want to hate my body forever. I want to love this body. And I will. But that’s different from it doing what I want it to do. It’s different from feeling supported to take care of myself.
So this comes back to correct what is a very egregious problem of women suffocating and drowning. It’s more than picking yourself up by your bootstraps. It could be worse. Of course it could be worse. That doesn’t mean that this is great. We’re allowed to not be happy with the current state.
Dr. Sierakowski: One of my favorite quotes – Just because I carry it well doesn’t mean it’s not heavy.
Author’s note: Is anyone else singing “Surface Pressure,” Luisa’s song from Encanto on repeat? I am convinced this song is a parable for motherhood and it speaks to me.
We have to start talking.
Dr. Sierakowski: We have to start talking about it and we have to support each other or maybe reimagine what true support looks like in the modern world. Historically it’s been a village, a family, multi-generations living in one house, for better or for worse. Most people say “I wouldn’t want to do that.” Ok fine. I get it. We have issues with our families. I moved very far away from mine. I love my mother and we’re 500 miles apart and that’s ok. But for better or for worse, I don’t have that support. And there is always the argument, “well you chose that.” Sure, I did. And? It doesn’t make it easier.
I think we very much need to reimagine what support for the transition to motherhood looks like. What is the village? Where is it? How do we find it? How do we craft it? And how can we work on that collectively? It doesn’t have to be blood family. For millennia, it wasn’t. Whatever village you had, that’s who was going to help you raise your children. And that’s the secret nobody talks about. This doesn’t stop when labor happens. It doesn’t stop when your kids are three months old. It doesn’t stop when they’re four years old. To exist as a human being is a collective experience and we’re missing out on that. Now dramatically, since the pandemic.
Not every pregnant woman glows. I sure didn’t!
Dr. Sierakowski: Pregnancy hormones are very real. And that sets up a really unrealistic expectation that goes back to the body failing part of “my body is designed for this.” That’s true but it’s being misinterpreted. My body is designed to do this. Yes, I’ve created life. It doesn’t make it easier. It doesn’t mean I’m not also going to make varicose veins and skin tags and stretch marks and hair changes and acne and skin folds and all of these things that are not fun or cute or goddess-like. But they’re very real and that’s where the reimagining needs to come back into play. I am capable and I am strong. And it’s hard and I need to talk about it.
We shouldn’t have to ask for permission for basic self care.
Dr. Sierakowski: [Motherhood is] constant, constant, constant responsibility. Working and living for everyone except you.
Author’s note: Not being able to prioritize yourself ever. Or if you can, it’s a gift. It’s a “I would really like to go get my nails done” or “I would like to sit and have a cup of coffee”. We shouldn’t have to ask for that.
Dr. Sierakowski: That’s this concept of default parenting that’s now being talked about a lot which is good. We need to talk about it. To ask permission to go to the bathroom? It sounds ludicrous but that’s what happens. To say to whoever else may be in the house”I need a minute”. Or for the great many women who don’t have anybody, what do you do? You’re asking the older kids to help the younger kids so you can go have a bowel movement by yourself or everybody just comes into the bathroom and has a party with you. Which is safe and fine but you lose part of your humanity.
My body physically cannot stand up to everything I have put it through. Is that because of the trauma of pregnancy/labor/delivery?
Dr. Sierakowski: And hormones. And histamines. Also genetics and epigenetics. There are so many reasons. It’s all part of the same problem. We are here because we didn’t have enough support before we got here. And that’s important to recognize. It’s not your fault. It isn’t “well this just happens”. Mom bod and Dad bod are just things that happen. No. They are things that happen when someone wasn’t allowed to have a healing first 40 days where they stayed in bed and someone else did literally everything else. Your only job was to bond with that new baby.
I don’t know anyone for whom that’s true. So how is it that we send people out of a clinic with a sprained ankle with more rehab instructions than we do women who have birthed a child.
You have a 5-minute 6-week postpartum visit where the doctor says “cool everything looks great! You’re allowed to have sex again! Have fun!” Can we talk about exhaustion? About feeling broken?
We cannot and should not be doing this alone.
Recognizing that, wherever you are right now, it’s a collective experience that was unsupported. Or not sufficiently supported. That’s important because to move forward, we have to get it out of our head that we can somehow do this by ourselves. You cannot do this by yourself. You can’t. Anybody who says they are is absolutely lying. Or not understanding that they have some kind of unrecognized privilege that they are actually getting supported in a great many ways and just don’t know. You can’t do this by yourself.
But there are just so many questions. So many insecurities.
Dr. Sierakowski: So many women come to me saying: “I don’t like my body. It’s not doing what I want it to do. My brain doesn’t function. I feel like I’m being put out to pasture. How do I work? How do I have a purpose besides my children? How do I feel sexy again? How am I supposed to have sex if even the thought of it is repulsive? And not because of my partner, whoever that is. But because I don’t want it.” It’s not always true but it’s frequently true.
Dance naked in front of a mirror.
Dr. Sierakowski: The idea that we should just somehow convince ourselves that looks don’t matter, is totally ludicrous. It’s never going to happen. We can pretend and it’s never ever ever going to happen. And I think there is an important reason there and it doesn’t have to be because I don’t like the way I look. I don’t actually want that for people. I frequently give homework and this is free. You stand in front of a mirror naked and you dance, by yourself. Close the closet door.
Author’s note: My face could not hide the absolute shock and horror of this prospect.
Dr. Sierakowski: That. All of that feeling and emotion, that’s why we should do that. Because loving this body, that has brought us through 100% of our hardest days, that has maybe created life, that has handled surgeries, that has been traumatized and come through it, that walks us around or whatever it is that this body does to support us every day. We have to love this body or we will never heal. That doesn’t mean that you have to look in the mirror and say “I don’t want to change.” Acceptance and desire to change are two different things. Acceptance does not mean stagnation and I think in our minds it does. Well but if I’m ok with this body, if I’m ok with where i am right now, then that means I won’t ever get better because I’m ok being here. It’s not the same. I want to be proud and loving and okay with who I am right now today, and work towards change. That’s possible.
Remembering that the physical, what we see, is how we take on our world. And we’re using how I look as a marker for how I function. They are also not the same thing.
What can woman do?
Dr. Sierakowski: I would love for someone to have an entire team of people. And when I can, I do. I send someone to a functional integrative doctor. I’ll send them to a chiropractor, who understands the pelvic floor. I’ll send them to pelvic floor physical therapy. There are entire therapists dedicated to the pelvic floor that help you with those things. Acupuncture, massage. And all of that is viewed as really superfluous. It’s like getting your nails done. It is not the same thing but that’s how it’s viewed.
A facial and a massage are lumped into the same category and it’s not true. A massage works trauma out of our bodies.
All those resources, being viewed as superfluous, are not accessible to so many.
Dr. Sierakowski: [Accessing everything is likely out of reach for most]. So we prioritize. Good quality vitamins. Knowing what it is that somebody needs.
Your body has been depleted. Mind, body, soul, vitamin, bone, blood, sinew, everything has been given over to other human beings. So we have to rebuild you. And you can’t do it by yourself. So understanding what that means. I can easily imagine that some women can feel despondent hearing that. Well I am by myself so what do you want me to do? Never ever. You’re never by yourself. There are so many free resources. Get on the internet, get on facebook, find a group. There are free ways to access other women who can support you. Even if it is “only” talking or “just” venting. Those are powerful things. And then you get access to this whole other community who may have tips and tricks for you that you don’t have to pay for.
Even with all the resources in the world, sometimes things just happen.
Dr. Sierakowski: Start by separating a distaste for a particular physique from “how do I feel and really function better”. For myself currently and for a great many women, I have coached them on “focus on what your body can do. Focus on strength not skinny.” Just starting there and remembering that every journey is a step at a time. We actually have to take the steps. And a lot of times, that’s where we get stuck. It’s the, ‘I want to be way over there and that’s so overwhelming and it feels so unattainable that I don’t know how to navigate the borderlands. I don’t know how to navigate this weird in between where I’m not on and I’m not off. I don’t know how to start’. That’s where the resources and talking to other people come into play. You say I’m going to focus on what this body, where it is right now, can do. Not on what the body that I want can do.
What is the first step?
Dr. Sierakowski: It’s going to depend. I walk through with every person and say “What is really the most broken? Is it your hip? Is it your pelvic floor? Is it your spirit?
So sometimes the homework is to go dance naked every day for a week in front of a mirror until you don’t cringe when you take your clothes off. Until you don’t avoid looking at yourself. Until when you look at yourself it’s not to glower and pinch folds and say I’m tired of this. It’s “thank you body. Thank you for doing what you’ve done”. So we start there.
Everyone should do a postpartum recovery course. If you’re 2 weeks or 20 years postpartum.
Dr. Sierakowski: Triangle Chiropractic and Rehab has an online, on-demand postpartum recovery course. It’s $99 for 6 weeks. It is worth doing because, even if someone hasn’t birthed a baby but has any issue with diaphragm and pelvic floor, it works anyway. If you have a diastasis, a split in the stomach, which is totally physiologic, every pregnant woman has it, we have to actually heal from that. But women and men get the diastasis for other reasons as well, that rehab course is a foundation to movement because many many people are trying to run when they can’t actually stand straight.
Work to love yourself, not hate yourself.
Dr. Sierakowski: Do a foundational course on pelvic floor and diaphragm rehabilitation because without the core of your body, the rest of you is not going to function very well. Truly. If that is out of reach for someone, then I would encourage you to YouTube “diaphragmatic breath”. Diaphragm breathing and something called the functional progression – a series of movements that babies do when they are born. So you start on your back and you can move your arms and legs independently, then you can roll over, then you crawl. All of those are very specific neurodevelopmental steps that adults can also go through to rehabilitate our core.
Slow is fast. Do not run before you walk.
Dr. Sierakowski: Sit with yourself and be honest about where you are. Start there. This is very tortoise and the hare. Slow is fast. It’s true. Maybe you used to run and think you should be able to do it now. But listen to your body. If you run before you can walk, in 6 months you may not have made any progress or even injured yourself. That is my primary advice to people. Do not do this by yourself, find your community, figure out what resources you have. Actually prioritize taking care of yourself and that’s not just taking a bath.
Author’s note: I don’t think of a bath as self care, it is a basic hygienic function that, for the rest of the world is not self care. It’s just, I need to be clean. I think it is also about having conversations with everybody around you that self care is not selfish. That it’s not an option. That it is a very basic fundamental need and we shouldn’t have to ask permission to go take a shower, or even to go get our nails done. I try to schedule everything during naptime, why? Because otherwise I’m going to get these phone calls saying ‘where are you?’
We need to have the conversations, both with ourselves and our village.
Dr. Sierakowski: The conversation has to be had. And there are two sides to it. There is everyone else and there is the internal. So have the conversation with ourselves as well because we have to believe it before we start asking.
Constantly asking permission? It’s a habit that somehow we get into. We just fall into it. Oh well he’s busy, or he’s resting or she’s doing other household chores so I need to be with the baby. Except, we take on all of those rolls all the time by ourselves with no help and don’t ask. A lot of times that’s because asking is harder.
And this is where the conversation gets frustrating. It’s very easy to say “well just ask for help” or “just leave the room”. He’s [my husband] literally not paying attention. Like if I just leave, someone is going to get hurt. This isn’t actually about me at this point. I have to get his attention to supervise because I am default supervising all the time. So if he just leaves it’s because kids are cared for. If I just leave, it is totally possible that they are under no supervision because someone is not paying attention. That can be “cured” with practice. But that requires a conversation with your partner. And I just call attention to it over and over again. Are my husband and I having some testy conversations right now? Absolutely. Is it important? Yes!
Because it’s things like “you just walked out and are on the phone for a work call. I want to respect you and your work so I’m not going to walk out there to interrupt your work call to say you just walked out on me while I was going to go do something. You’ve prioritized yourself instead of prioritizing me. And this is what happens over and over and over again. But you damn sure as soon as that phone call is over again, we have to have that conversation.
If you don’t take a break, your body will take one for you.
Dr. Sierakowski: Talk to your partner. Do a better job of sharing responsibilities. Get other help if (when!) you need it. Whatever that looks like. But you cannot do it all. And that’s going around too. “Stop trying to do everything” was popular for a while. And now that has been replaced by “well then who the F@#$ is going to do it?” You have to figure it out because what happens is, everyone ends up here in my office burnt out and injured.
If you do not take a break, your body will take one for you. And it’s not fun. So it’s the hard truth when someone says I can’t. You can, but it’s about prioritizing. And sometimes that’s a hard conversation to have. And that’s the internal struggle of “I don’t want to ask. I don’t have a great relationship with (insert family member here).” Understood. Is navigating those waters worth it in order to not navigate those waters by yourself because there will come a day when you can’t and then what? So it’s not always exactly the way we want it to be. It is rarely the way we want it to be.
Prioritize your healthcare.
Dr. Sierakowski: When I first started here, someone said something to me that has stuck with me, and bothered me, ever since. He called to find out what we do and said, very derisively, “oh you take care of healthy, wealthy people.” And I said “absolutely not.” But it took me a while to figure out what to say back. That’s not true but what is it that makes it different? I take care of people who prioritize their health. That is who I care for. And it is a spectrum of people.
Dr. Elizabeth Sierakowski is fully conventionally trained in western medicine. She is also trained in integrative and functional medicine. These two categories, different but with a lot of overlap, blend conventional medicine (drugs and surgery) with alternative evidence based methods and modalities. She looks at the whole person, spiritually and physically.
This article was originally published on WRAL.com on 9/27/2022, written by Nili Zaharony, WRAL contributor. See original article here: Local physician: Our bodies are not failing us