Fertility & Sexual Health with Sandra Milliken
Episode Description:
I'm really excited to be joined today by Sandra Milliken, a nurse who has worked in various areas of medicine and has settled into sexual health clinics and fertility clinics. Today we go over all sorts of areas of sexual health and fertility, and some things Sandra wish more people knew.
Resources mentioned:
https://smartsexresource.com/
Sandra's IG: Sandra.milliken
Sandra's Goodreads: sandra Milliken
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Episode Transcript:
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Hi, welcome back to Rebel Movement podcast. My name is Billie, my pronouns are they/them or she/her. I'm really excited. For a lot of the episodes we're doing recently– Today we're kind of expanding on our– I would say kind of taboo topics. I don't think they should be taboo, but I think that unfortunately they kind of are. I'm talking with my wonderful friend. Sandra about sexual health. And fertility and just in– as– just the same as in the last episode we did menstrual health, this episode is also very gender neutral language. There's not– I don't think there's a single. Even medical like, jargon thing maybe– I mean, jargon in terms of like female male mentioning.I could be wrong because I recorded this like last week, but I am stoked about this episode. Just like the one with Ashley, I feel like this is going to be, I mean, we already know this is going to be one of a couple of episodes. I'm stoked about it honestly. So, I’ll just let you enjoy the interview and– oh I’m so excited to hear what you think.
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Thank you so much for joining, I’m really excited for our conversation, do you mind talking or telling us a little bit about you and as well as your pronouns. And your name.
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Yeah, yes. Let's start with the name. My name is Sandra. My pronouns are she/her and, Billie invited me on this podcast to more discuss kind of like areas of work that I've worked in. I'm a registered nurse and kind of worked all over the place in Canada, but, as a travel nurse and in the hospital and things like that, but lately in the last few years I've kind of honed my focus into what I'm really passionate about, which is sexual health and reproductive health. I moved to Vancouver a few years ago and worked in a fertility clinic for 3 years and then now I'm up in the Yukon territory working at an SDI clinic and I'm loving it. So that's my Coles notes.
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Yeah, that's awesome. Yeah, thank you, I appreciate that. Was there anything that– like any moment or incident or I don't know, thing that happened that made you really decide to go into fertility and sexual health?
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Honestly, it's really interesting in– not really, I guess not really that interesting, but I think everyone in nursing school thinks, you know, oh, I'm gonna be Emerg, I'm gonna be ICU. And for me, it was like, I was gonna be pediatric, so it's like, I wanna work with kids, I wanna work in the NICU. Like, and I tried those areas out and I did really like them. Like I didn't hate them by any means but they weren't– I wasn't super passionate about it like I thought I was going to be, and then in Kingston I got a job casually on the sexual assault and domestic violence team, and it kind of opened my eyes into like the areas of reproductive health and sexual health that are underserved, and trauma-informed care, I became really passionate about kind of implementing that into my daily practice and I realized I wanted to work more with that kind of population. I guess, have just like– talking about sexual health and destigmatizing things, and talking openly, and making people feel comfortable discussing that and that was kind of a big way to get introduced to that area but I really really fell in love with it and then when we moved to a bigger city I thought okay, what other areas are not related, like fertility is not at all related to sexual assault nursing by any means but, in a way that you're talking about things that are very intimate, very personal, and making people feel comfortable in a moment that they might not be. So yeah. Yeah.
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Yeah. I can imagine that the trauma-informed care would come in handy in that kind of working environment day.
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Definitely, it really did. Yeah, I would regularly like host, learning sessions about trauma-informed care and things like that just for– like informally for my coworkers just because it– I learned so much about it in my previous work and it's so applicable to every area of work not just nursing, but every area anywhere.
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Yeah. Yeah, I totally agree with that. Yeah. Is there one– I guess this is not necessarily specifically on the topic, but is there one– I know it's a really big topic as someone who's also done some trauma-informed learning– Is there like one piece of advice that you would– Is like your go-to to give folks?
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Oh man, so many. What's my one piece? I'm big on like breaking down, kind of making sure everyone knows who I'm talking to, everything I'm laying out is an option, and they get to pick and choose. I sometimes call it like a “choose your own adventure” particularly with, like I'm thinking of my current role as an STI nurse. I sit them down, we talk about you know how the appointment is gonna go, and then I say you know like, I'm gonna lay out a bunch of options for you, you get to pick and choose what options. I'll help you like weigh pros and cons if you need to. Those are the kind of– and just letting people know that they can kind of opt-in, opt-out whenever they want, and like putting that kind of out there before you even start an interaction with someone I think makes people feel really comfortable right off the bat, and allows them to have a little bit more autonomy in a relationship where you definitely hold the power.
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Yeah, that totally makes sense. I really like– it feels really nice to hear that there's someone that works in this kind of setting that has that type of approach, because I know that it can feel– There's like a lot of emotions that can come up when you're having to deal with that kind of thing and not all clinics, or doctor’s offices, or whatever environment, are very welcoming.
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Totally. Yeah. And I think any person who's accessed healthcare has probably had, maybe a lot of positive experiences, but also maybe some negative experiences with healthcare providers, and it doesn't foster a trusting relationship, which means that you're also not being able to provide the best care when your patient doesn't trust you, so yeah.
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Yeah. Yeah, that makes sense. So I know there's a lot we could talk about in this topic, because it's like multiple topics in one, at least as an outsider’s perspective I have no– I'm not, I do not work in health care, I'm not an expert in this area.
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All good.
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Is there anything particular that you're like, stoked to start talking about in terms of like in this podcast or if not, I can ask you a question, but I just wanted to throw it out there just in case you're like, oh, I gotta make sure we talk about this or–
This is one thing I wish more people knew.
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No– maybe I'll throw in a little pitch for an HPV vaccine–
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Yeah, go for it.
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I've been really passionate about HPV vaccines lately. I need to cite my sources, but I'm just gonna– word-of-mouth – basically the HPV vaccine is otherwise known as gardasil, helps prevent against several strains of HPV that can cause cancers, and not just cervical cancers it's good for men to get too especially like queer men or queer people with penises,
who– because the– it can prevent against pro-cancers and anorectal cancer. It's a really great vaccine and it's proven to be very effective. And there were recent, studies, in Europe somewhere. I'm sorry that I don't have the exact source–
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That's okay.
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But recent studies that were done that– they, studied a bunch of people that received it in childhood and went on to– and– basically we're trying to measure how many people did develop cervical cancer later on– And they thought that their results were, there was an error because the result was 0. They're like, this can't be right.
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Wow.
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And so they repeated the study and it was right. Like it's that effective at preventing at least cervical cancer, we don't have the studies to back up the other stuff, but I would, you know, hazard a guess that likely, good at that too.
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Yeah.
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So anyways, basically get your HPV vaccine, if you still can, if it's like free. Certain provinces and territories have different regulations on who it's offered free to, but–
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Oh, true.
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Ask your health care provider if you can get it for free or if you have– if there's any way that they can write a letter to get you that vaccine because it's a– It's just so effective and I've just been thinking about it a lot lately, about how we need to advocate for it more.
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Yeah, here in the Yukon everyone under the age of 26 qualifies for free which I think is very– Like it's good, but it's not as good as it could be.
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Oh cool. Yeah.
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Like it's– I think it's one of the best policies of any of the provinces or territories but– Still it's, I'm like every 20 year-old I'm like oh get your HPV vaccine–
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Hmm. Yeah, get it while it's free.
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So anyway, that's my pitch for the beginning of the podcast, but we can talk about other stuff.
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I like it. No, that's okay. I've actually– I have had my HPV vaccine. I had– I don't know if it's still like this cause this was quite a while ago, but there was three– like you had to get three of them. Is this still like that now too?
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Yeah, it’s a series of three, yeah. One is better than none though, is what I tell people, like if you have to pay for– if you go out, want it, and you want to pay for it, you can pay for one, better than, you know, zero. But yeah, yeah, yeah.
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Yeah, yeah, that's true. Yeah. Cool.
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Yeah. That's great.
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I'm trying not to go into my story, about why I had to get it, for some reason, but, Yeah, I really appreciate that at the beginning, cause I do think that– I don't think this stuff is talked about as much as it should be and just, I did an episode– I just was telling you this, but just in case anyone listening doesn't know this, I did an episode a couple of– well for me, it was a couple days ago but if you're listening it was probably longer than that– About like menstrual cycle and menstrual health a little bit, and I am not someone I would say that has like not learned anything, like my mom was– growing up was a nurse and I, you know, she had diagrams and I, still there was things that I was like, oh. I didn't know that. I didn't– like it feels really–
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Yeah, yeah. Oh, there's so many wild things that you learn and I'm talking like just starting at the fertility clinic and learning like more about the menstrual cycle from a fertility point of view, I was like, my mind was blown. Like I had no idea how any of this stuff worked. And that was only a few years ago and I'm like–
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Oh yeah.
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In nursing school, I didn't learn in any sort of like capacity that I've ever had, so you are not alone.
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No, I'm glad for that. Was there anything in– either in menstrual health or sexual health or fertility, was there anything or maybe a couple of things that like really stood out to you as– I guess, as blowing your mind? I don't know why I said that such a complicated way.
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Yeah, yeah. I mean, at the fertility clinic we mostly were, working with couples or single people who wanted to become parents, who were undergoing IDF or in vitro fertilization, or IUI, which is intrauterine insemination. So the difference between those two basically is that an IUI, we're timing out when that person ovulates and we're putting sperm in there at the right time and hoping that it meets the egg.
So it's a little bit– a lot less invasive, I should say. But the chances of success are lower just because it's not, you know, done in this– We're trying to hope that they meet each other rather than making sure they do.
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Right.
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IVF on the other hand, a person is undergoing an egg retrieval. In the lab, the sperm and egg meet and then they do a– like they grow into an embryo and then they transfer it back in. So in terms of like what really blew my mind with the– I got a lot of questions about like well if I'm getting an egg retrieval like are all my eggs gonna be gone? Like, are you taking all of them, like will I still have them? What was really interesting is that like we actually– people who have eggs have like a cohort of eggs every month for their cycle, and that cohort of eggs kind of like grows together. In the follicular, beginning phase of your master cycle before you ovulate, one egg is chosen as a dominant follicle that– they all live in these follicles, which are little egg houses basically, so one follicle is chosen dominant and the rest of them just kind of like shrivel away and they're like gone, they just get wasted by the body. So it was interesting, about IVF that we would harvest the– harvest is such a gross word to use, I'm sorry– but take the eggs from that cohort only. So you can't, it's not possible to retrieve all your eggs, if that makes sense. It's only the ones that your body would have had made available for that month alone.
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Right.
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And then the next month, you got a whole new cohort of follicles, eggs in their follicles. So that was kind of interesting and each person has like a different size of cohort, it depends on your age, it depends on so many different factors, genetic factors, etc. And I was just learning so much about that in itself. I was like, I didn't know I had a cohort of eggs every month–
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No, neither did I.
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But that you know like grows and then I have a dominant one and that's the one that gets to ovulate, maybe two if you're one of those ones again, could result in twins kind of thing, but yeah basically that's it.
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Whoa.
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I thought– I found that process really interesting and fun to explain to patients, I really like educating people about their bodies too, so I thought that was really interesting. Yeah.
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Yeah. Yeah, that is really interesting. I didn't know that either. I didn't know that you had cohorts.
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Yeah.
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Is it in– This feels like a ridiculous question now that I'm trying to say it out loud, cause it seems like it would be invasive, but is it a really invasive or like painful or difficult procedure to have the eggs taken or harvested or however the technical term is?
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Yeah. Yeah. I was a nurse there but I was also a patient there so I also did do an egg retrieval when I worked there. Which was interesting and cool to be on like that side of the team if that makes sense.
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For sure.
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And so I got to experience it first hand and yeah, like I, I knew it was going to not be comfortable, like the, the lead up to the egg retrieval you're doing– you're doing injections every day to grow– not only grow your follicles but also stop you from ovulating because when your follicles get to a certain size your body’s like gonna want them to ovulate, you’re– that's that's natural. But you want them to grow, but keep them inside until we can get them right.
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Right
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So you're doing injections. And that part– like I don't love needles so that part wasn't fun, but it's not horrible they’re not like intramuscular injections they’re in your subcutaneous tissue in your lower belly, so it's not terrible. But then the procedure itself, you have to get, it's like a guided ultrasound, so it's intervaginal. And then they use a needle with– attached to basically a vacuum that hooks into each follicle and sucks the follicle out.
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Oh, whoa. Yeah.
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That makes it– not the follicle out, but the liquid that's within the follicle.
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Huh, yeah. Yeah. Oh.
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So it's kinda like bubbles that you're sucking out the liquid inside the bubbles, so if that makes sense.
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Whoa, yeah, that makes sense. Cool.
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Yeah, so obviously you need a lot of pain meds. They actually gave me fentanyl, which is very safe to use in a healthcare environment with the proper dosing and all of that stuff. But yeah, and I was fine, it was okay, I didn't find it super painful. My partner did find it very painful, but she had a lot more follicles than I did, so her procedure was a lot longer.
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Oh. That makes sense.
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So she had to kind of undergo it for a lot longer than I did. Poor thing.
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Yeah, that's makes sense. It's just like very different. Yeah, poor thing. It's just different person to person then.
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Yeah. Yeah, totally. She had like way– she had almost like a concerning number of follicles–
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Oh, interesting.
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A high number, a super high number can maybe indicate PCOS so we weren't sure if like, some of those follicles wouldn't have like high quality eggs, but we ended up both getting really great numbers overall, so we're pretty happy with our results, but–
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That's good.
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Yeah, yeah, ended up okay. But, yeah, unfortunately because she had so many follicles her procedure was just like a lot more and her– even leading up like it felt like, she's like, I feel like I'm– she's never been pregnant but she's like, I feel like I'm pregnant, I feel so– like I have I'm having trouble like walking and moving around. Cause like her ovaries, your ovaries are normally the size of like almonds, and by the time she was ready for her egg retrieval, her ovaries were the size of oranges–
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Oh my gosh. Oof, no wonder.
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So both of them were just like very, she felt very full.
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Yeah, yeah, it makes sense that she would, that sounds– I can't, yeah. That's one thing– sorry that made me think of something else. That's– sorry, I'm gonna just say that sounds really painful and I can understand why it would be– Oh, poor thing. I didn't know until recently, this is– I mean, this is related, but not exactly like– it’s similar. Anyway, I saw a picture which– this could be, you know, I'm not saying this is facts because I'm again not the health care worker–
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Okay, sure
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But of– is it your– Wow, see now I can't remember any of the terminology– of your, is it your uterus before and during like before you period and during your period?
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Yeah, yeah.
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And the size difference, isn't it like? I don't know if it doubles or if there's like a big difference or–
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I mean, I'm not sure about that actually. I don't know the like size difference, but I'm sure it gets bigger with the lining increases throughout your menstrual cycle, and then sheds and probably kind of– because it kind of collapsed– people think of it like it's like an open cavern like an open space in your body–
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Yeah. Oh, yeah.
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It's really kind of like collapsed on itself, you know, and then– until something's in it that it needs to hold on to.
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Right. Oh, that's cool.
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So yeah, probably if it has a thick lining then it would be less collapsed on itself so it would be bigger.
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Yeah, oh that makes sense.
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Is what I'm thinking, but I don't know the exact, you know, size difference, but–
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Oh, that's totally fair. I'm just like throwing random questions out at you.
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But it's so interesting. Like it's like– I don't know, reproductive health is so cool and so interesting and not to, I didn't mean to like fear monger anyone about fertility treatment, we had a really great experience and we weren't like–
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Did you?
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You know, it wasn't super horrible. It wasn't like super painful or anything like that. We both had our like, pains meds were very well controlled. I got some ativan too, we both did beforehand and I felt great.
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Yeah. Did you? Okay. Yeah.
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Yeah, I love ativan. It really– I've never taken it before, I haven't taken it since, but I was feeling pretty good.
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Pretty good? So the pain wasn't too bad?
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Yeah, so I mean it wasn't– No, it wasn't unbearable. I actually, I think I hyped it up more in my head than I needed to. Just because I've just seen so many people go through it, leading up to my time.
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Oh yeah.
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So I'd seen people tolerate it super super well and seen people have a really hard time, so I was like, oh god, what is it gonna be like for me? But it was okay for me.
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Yeah, that's good.
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But yeah, but I do that even with like a flu shot. I'm just like, ahh! And then I get it.
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Oh, same. Same.
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I'm like, I mean, I love the vaccine. Don't get me wrong, but needles are still scary.
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Yeah, yeah, I definitely get nervous for anything like that or I build up in my head that it's gonna be this horrible thing or you just don't know how it's gonna go and it could go badly but it probably won't go badly.
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Totally. Yeah.
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And then it happens and you're like, oh, good thing I didn't panic. Like, yeah.
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Yeah, yeah, good thing I didn't really ruminate on this for a really long time leading up to it here.
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Yeah, like, for weeks. Oh, man. I can imagine it would be a really emotional– I mean, I guess not for everybody because everyone's different, but I can imagine at times where some folks would be a really emotional process too.
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Oh yeah, I like sobbed on the table during my– I think it was also fentanyl induced. Fentanyl can make you quite emotional. It’s a very like short half-life, meaning it like works really quickly and then leaves your body really quickly. But I– so it– Just like that feeling can really like bring out all the emotions plus you're like dosing yourself up with hormones like for two weeks beforehand so yeah, so it can be emotional in many ways then I'm also not someone who like– I was doing it for– after having tried to have a pregnancy, right?
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Like, I think can be, emotional in a very different way and probably a lot more emotions for someone who has been trying to get pregnant for many years and then, not successful–
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Yeah.
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And not– like leading up to like this big moment where they're kind of just putting all their trust in to a team of people and that can be really scary and I'm sure really emotional and yeah, I wasn't doing it for that reason, we were doing it for fertility preservation reason. Knowing that we will need fertility treatment when we’re going to have like children so it will get emotional then I'm sure–
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Oh, for sure. Yeah.
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When we're actually trying to get pregnant, but for now it's just, yeah I feel like- for my patients I could really see kind of why they would feel the crazy huge amounts of emotions that they're feeling. Yeah.
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Hmm. Yeah, that makes a lot of sense. Yeah. I can imagine. What is– oh, I just forgot the term you just used– Fertility preservation?
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Right. Yeah, like egg freezing so– a lot of– so IVF really, specifically is freezing embryos, like so an egg and sperm joined and grown into an embryo and then freezing that. Whereas egg freezing that I did with my partner, we both froze eggs, just our eggs. We don't have sperm yet. So that's just frozen the way that they are. And that's usually done for like fertility preservation reasons quote unquote, meaning like, you know, I'm not sure if I wanna have kids, but maybe I'll want them later and like, you know, I'm getting older and I just wanna like, you know, put that in a box and like that can be my little like insurance policy kind of thing. There's no guarantee ever. Like it doesn't mean that, you know, it'll definitely work later. But at least, you know, I'm in my thirties, I froze my eggs when I was 30, my partner froze hers at 28, so it'll be nice to know that like, okay, even if we wait like a little bit longer, like I don't have to stress out about my biological clock or whatever people are saying now. Yeah, there's a lot of pressure on the people who can bear children to do it soon and maybe do it before they're ready and so I love that it's an option for us. I hate that it is not a financially affordable option. Yeah, it's– one day hopefully we'll have some more like incentives or like tax breaks and like reimbursement state programs and things like that, but like for now, it's very unaffordable and not on the table for most people, I was lucky that as an employee I got a discount–
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Oh, that's good. Yeah.
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Which is nice, but yeah it's not easy to afford for sure.
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Yeah, yeah. Yeah, that's definitely something I've– I feel like is seen a lot and talked about a lot, is that like your biological clock is ticking, there's– I've definitely felt that pressure, where you’re like, do I want? Do I not want? Like what if I–
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Yeah, and then you're like– You know, how do you make that decision? You know, like that's also a life-changing decision. I'm not even sure if I want kids and I just like–
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Yeah.
And after I froze them I was like, do I even want this? Like I don't know like that's a huge decision right and then, yeah and it's stressful to have to make it under pressure, I think, I’ve heard people who’ve felt that way, you know.
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Oh yeah, for sure. And then I've heard from some folks with uteruses who've tried to go to the doctor, and who don't– who know for sure they don't want kids. Like tried to go to the doctor and ask for like their tubes to be tied or– I don't know if there’s other procedures– and the doctor's response is like, oh, you might change your mind.
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Yup. Yeah. Don't get me started. Oh my gosh. That makes me so upset. Yeah, or like, have you talked to your partner, like your husband about this? You're just like, excuse me? Like, why do they get a say in what I do with my body? It’s wild.
00:23:37.000 --> 00:23:39.000
Yeah, yeah Yeah. It is wild.
00:23:39.000 --> 00:23:48.000
Yeah. And like people who get vasectomies don't get questioned like people who have vaginas, so– doesn't make a lot of sense to me. But yeah, yeah.
00:23:49.000 --> 00:23:57.000
No, me either. Yeah, and I had– I knew one person who– they had other health issues, which meant– I don't know all the details, but– Which meant that getting this procedure would be– Like save them a lot of pain and suffering or whatever, and even still they were facing this barrier, and their partner had to like come into the doctor and like sign something or just explicitly say–
00:24:15.000 --> 00:24:16.000
What?
00:24:16.000 --> 00:24:20.000
Like, I know about this, I'm fine with this.
00:24:20.000 --> 00:24:21.000
That's so wild.
00:24:21.000 --> 00:24:30.000
Like they had had their treatment, and– Yeah, it is, it's wild to me that that's– I don't know, we don't.
00:24:30.000 --> 00:24:31.000
Yeah, should not be okay.
00:24:30.000 --> 00:24:31.000
No.
00:24:31.000 --> 00:24:35.000
I don't know why that is treated like it's something that's normal when it's really not. There's a lot of like patriarchal norms in health care that like, persist to this day and I find it really insane. Like not quite to the infuriating level of that, but something that would always bug me so much was that– every day when I worked at the fertility clinic, we had– there was a certain test that had to be done before you got your appointment with the doctor. So you need some, certain blood work tests on– everyone needed STI testing because it's just for like you know, a fertility clinic, needs to make sure you're healthy and like if there's any issues we need to sort out before we get you started like– nothing's a barrier it's just more like let's see what we're working with kind of thing–
00:25:15.000 --> 00:25:16.000
Right.
00:25:16.000 --> 00:25:19.000
And for people who would be doing like an egg retrieval, they needed to get like a blood work test called an AMH, which is an anti malarian hormone test, and it's kind of an estimate of the number of follicles you have each month, it's a blood work estimate of that number. And in BC where I worked it cost $70 at the time– I think it's a little bit more now– but it costs $70 to pay for it, which for somebody who's doing fertility treatment, it's like a drop in a bucket. Like sure, it's not a lot of money, like whatever, but– then for someone who's you know, giving this sperm to this procedure, they get to go and do a free semen analysis.
00:25:58.000 --> 00:25:59.000
What?
00:25:59.000 --> 00:26:12.000
And I'm like, how come a blood test that's like, just running it through a machine likely, costs $70 and a semen analysis where you have to look at sperm under a microwave and take like seven or eight measurements of the sperm, that’s free. That's free. That's paid for with your health card. So I'm like– Not that it shouldn't be, I'm not saying that– But I'm saying, how come this like very basic fertility indicator is free for one half of the population, and then this other one– Like, I’m just like – oh my god, like this would drive me crazy. I'm just like, oh my god, this would drive me crazy. I was like, I'm so sorry that this is something you have to pay for out of pocket when really it's a basic fertility indicator that should be offered to everyone for free, but– Yeah, kind of wild. I didn't love that discrepancy.
00:26:40.000 --> 00:26:42.000
Yeah. It is wild. No, I wouldn't have either. Yeah, that would bother me as well. Oh, yeah, there's so much. I feel like there's so much part– so much of that part of the I don't know, that perspective of– perspective doesn't feel like the right word– That side, I guess, of sexual health and fertility that is, I feel like– I don't know, it's just so frustrating to see. I don't even know. I've had experiences before where– like when I had to go to the– get my HPV vaccine, for example, I had to get it because I had HPV. And the circumstances were not a positive one, we'll just say. And the doctor from the very first time I went in was so judgey and was–
00:27:34.000 --> 00:27:35.000
Like, what?
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Like I made this horrible mistake– Like you don't know my circumstances at all.
00:27:41.000 --> 00:27:54.000
Yeah, you also– every like I think it– I forget the stats so, sorry, but it's like at least, 7 out of 8 people who has sex is going to contract HPV.
00:27:54.000 --> 00:27:55.000
Wow, that's a high number, yeah.
00:27:55.000 --> 00:28:02.000
HPV is so common. It– there's like 40 different strains that kind of– like 200 strains that affect your body, 40 different strains that can affect your genitals, most of those strains are completely harmless. They just get cleared on their own, from your body, but like some of them aren't, and those can cause issues, and that's why we have pap tests and that's why we're introducing HPV screening, hopefully soon to everywhere in Canada, BC is introducing it–
00:28:19.000 --> 00:28:22.000
Cool.
00:28:22.000 --> 00:28:27.000
But yeah, it's not something to shame anyone for that's– and it's also like pretty invisible. It's not like you can ever really prevent, like contracting that– you know, I mean like, it's very normal it would be weird to not have encountered it at some point if you're having sex. Do you know what I mean?
00:28:37.000 --> 00:28:38.000
Yeah, for sure.
00:28:38.000 --> 00:28:42.000
So yeah, I'm sorry that you had that experience. It's really frustrating.
00:28:43.000 --> 00:28:54.000
Oh, thanks. Yeah. I think it's– also this feels I think a good like– it's gonna sound ridiculous out of again too– feels positive, like a good thing to talk about this kind of thing in the podcast and in general, because there's– when that happened to me, it wasn't really talked about very much. So when I had the situation happen, the person had said, oh, it's not contagious, and you know, did their mind trick bullshit and I didn't know any better. And then when I had to go through all this stuff like different treatments and the vaccine and stuff, I felt like alone in it, and there was this like, big scary thing that I felt– I like carried shame from that for years. But just hearing it– that it's so common is like oh, Okay, like–
00:29:39.000 --> 00:29:40.000
Yeah. So common. Yeah, cause no one talked about it then, so it makes sense that you thought you were alone in it, but it's just such a common thing and I feel like I have to like– Yeah, talk people down a lot in my clinic. Just like, cause what's– moving from HPV to herpes, which is HSV, which I think people also get confused a lot of time, but they are different. They're very different. So many people are scared of herpes. Not to laugh at it because it's not a funny thing to laugh about cause people don't– genuinely don't know, but like herpes is not harmful. Like it's annoying don't get me wrong, like it sucks because you get open sores that are painful, they go away, sometimes they come back, sometimes they don’t. Generally like they're okay. Everyone's fine. It's not gonna hurt your health at all long term, it’s just annoying. Like cold sores are just a nice way to say that– everyone's got cold sores. So. And my like favorite aside I tell people is that if we tested everyone's blood in Canada, 90% of people have antibodies to a strain of herpes.
00:30:45.000 --> 00:30:46.000
Wow.
00:30:46.000 --> 00:30:50.000
Because it's that common. Like people, some people are lucky and they don't get lesions, and some people are unlucky and they get lesions and we don't like test for it routinely, because we would have to hire a whole team of people to call everyone back and then talk like– and talk to them and be like, you're okay–
00:31:02.000 --> 00:31:03.000
Right.
00:31:03.000 --> 00:31:13.000
Like, you know, you don't get lesions. You're okay. You just probably encountered like– maybe you kissed someone who had a cold sore once, or gets cold sores, and you're okay, everything's fine. So I feel like there's a lot of like the destigmatizing that has to happen because in school we're taught that you know, you're gonna have sex, you get pregnant, you get an STI, your genitals will fall off, and you'll die. Like that’s what we’re–
00:31:24.000 --> 00:31:25.000
Yeah! That's totally it.
00:31:25.000 --> 00:31:29.000
Yeah, we're taught this like horrible stuff, right? And like, 99% of STIs are completely curable. 100% of STIs are manageable with medication. Like, 100%. These are– the ones that aren't curable are manageable and you– will not kill you, and you'll live a full long happy life with no health issues, with medication. That includes HIV–
00:31:48.000 --> 00:31:52.000
Wow. Yeah.
00:31:52.000 --> 00:31:56.000
Especially. So yeah, it's one of those things that we're just not taught, I think in our generation, we– I hope in generations, it depends where you grew up, but I hope it's getting better, but I don't think it is in a lot of places. But yeah, just. The sex ed needs to be less fear-mongering because people are gonna have sex. And then they don't know what to do when these things happen. You know what I mean? Like they encounter– find out they've gotten contact with chlamydia and they panic, and it's like guess what? I'm gonna give you 4 pills and you're gonna be okay. And like that's it, it’s very easy to treat so– Anyway, the stigmatizing of STIs and the shame that health care providers like put on their patients is completely unnecessary and like doesn't encourage people to come back and seek out care later.
00:32:42.000 --> 00:32:51.000
No. Yeah, that's true. Just in case anyone grew up in a place or grew up in an environment or place where they don't know what to do, if they suspect they have an STI or something, what would you suggest they do?
00:32:56.000 --> 00:33:06.000
Seek out– If you can, if there is an area near you– but if you go to specifically sexual health clinics, like an STI clinic, a sexual health clinic, if they specialize in that, they're gonna deal with this. They see what they see every day, they're gonna be able to answer all your questions, hopefully not in a shameful or judgey way because they deal with it every day. And you know they're not an uneducated health care provider hopefully. So if that is available to you then I recommend seeking out care at a specifically sexual health clinic. If not, if you have any– like any concerns about anything going on down there, I always recommend seeking out healthcare in the most accessible way that you can, just to make sure things are going okay, checking things out, it's better to like be safe and get the treatment and do what you need to do or get the testing that you need, just to put your mind at ease too, so you're not stressing about it. And there is a couple STIs where you get symptoms and then they go away and you think everything's okay, but it's still there lingering, I'm thinking specifically of syphilis. Syphilis is so tricky, but you can get symptoms and you're like, oh, that's weird. And then they go away. And then you're like, oh, I guess I'm good now. But it stays in your system until you get your treatment. So it is important to get things checked out when they do arise.
00:34:23.000 --> 00:34:24.000
Yeah. Yeah. That's helpful. Thank you.
00:34:24.000 --> 00:34:29.000
Yeah. And don't spiral on Google is my other recommendation.
00:34:29.000 --> 00:34:32.000
Yeah, that's a good recommendation. That's a very good recommendation.
00:34:32.000 --> 00:34:41.000
Yeah, yeah. Yeah. There's a very good website called Smart Sex Resource. And if you need to spiral on the internet, that is the website to spiral on.
00:34:41.000 --> 00:34:42.000
Smart Sex Resource.
00:34:42.000 --> 00:34:44.000
Otherwise– Smart Sex Resource. It's run out of–
00:34:44.000 --> 00:34:48.000
I'll put that. I'll put the link in the show notes. Yeah, yeah.
00:34:48.000 --> 00:34:49.000
Yeah, it’s in your notes. Cool. It's run out of the BCCDC for the BC Center of Disease Control and it's all up to date, not scary information, it's all like, good, clear, important information that's not gonna like freak you out and then it'll tell you, you need to go and get checked out. So. Yeah, great website.
00:35:07.000 --> 00:35:12.000
That's really helpful. And yeah, I'll definitely put that in the show notes. So if anyone listening, you could just like, I don't know, save it or have it as a bookmark if you feel like the need to spiral, go there.
00:35:14.000 --> 00:35:15.000
Totally, yeah.
00:35:15.000 --> 00:35:18.000
That's very helpful.
00:35:18.000 --> 00:35:28.000
Totally, yeah. Don't just type “herpes” into Google and press images. Like,
00:35:18.000 --> 00:35:28.000
No
00:35:28.000 --> 00:35:36.000
That's just like not gonna result in that, you know, calm, calm setting you want, like that's just not gonna help you at all because it's just Google and it has to pull up whatever it can, but it's not gonna be accurate.
00:35:36.000 --> 00:35:48.000
Yeah. Yeah, and maybe listen to this episode again because I– I'm not in the situation where I would need to Google, but I, feel like calmer about– I'm not, I wasn't even in the spiral, but I feel calmer about everything after this conversation.
00:35:48.000 --> 00:36:00.000
Yeah. Yeah, good. I'm glad. It was kind of, hopefully it does, we talked about lots of stuff– but yeah, we kind of circled all over the place, but hopefully it was helpful to someone.
00:36:00.000 --> 00:36:08.000
Yeah, I think so. Is there anything that you want to add, or that you wish more people knew, or anything like that that's coming up?
00:36:08.000 --> 00:36:14.000
Oh man, so many things, but to think point one thing, I– I don't know, touched on HPV vaccines, get it if you can. And yeah, get to– talk to your partners, I think that's gonna be my takeaway. I feel like I see a lot of people that are like, oh yeah, I'm coming in getting tested. I don't know if my partner’s been tested. I’m like that’s, it's a cute date to go together to get tested. Like, that's cute and hot. You can have more fun if you know, you bring your partner, your partners, to the clinic, I'll get tested, that really is some worry off of you, and then you can have a better time hopefully because you're not stressing about anything. Yeah.
00:36:50.000 --> 00:36:54.000
That's helpful. Yeah. I feel like I have so many questions for you, but I don't want to take up too much of your time, but–
00:37:01.000 --> 00:37:04.000
Totally fine. I can talk about sexual health, reproductive health, all day every day, so this has been fun. Yeah.
00:37:04.000 --> 00:37:05.000
Okay, so– yeah, I think so. Yeah, it's been very fun. Thank you so much, I've learned a lot from this. And I'm just trying to think if there's anything that I should ask before the end. There’s like 5 million questions just spiralling in my head, spiralling? Whirling in my head. I don't know. I feel like I can't, there's not time for all them, so. I’m gonna have to edit this part out. I don't know. Just rambling.
00:37:31.000 --> 00:37:32.000
That's alright.
00:37:32.000 --> 00:37:36.000
Thank you so much for sharing your time with us and– with me specifically, and with everyone listening. I really appreciate you coming on here and sharing all you know and sharing your time. Is there like, is there anywhere that you would want people to follow you or anything or?
00:37:54.000 --> 00:38:02.000
I mean, I'm not like an influencer or anything. I'm not like a nurse on the ground, but if you want to follow my book recommendations, it's pretty much my whole personal Instagram.
00:38:02.000 --> 00:38:04.000
Oh, good one. Yeah.
00:38:04.000 --> 00:38:12.000
It's just like my cat because I just got a cat, and it's pretty much a shrine to my partner. She's my Instagram muse–
00:38:12.000 --> 00:38:13.000
Cute.
00:38:13.000 --> 00:38:18.000
And my book recommendations and it's just my full name, first and last name: Sandra Milliken, on Instagram. So yeah. Yeah.
00:38:19.000 --> 00:38:30.000
You have some good book recommendations. I have you on Goodreads and I feel like every time you put something as like a 5 star, either I've read it and I think it's also that, or it's on my list and like, okay, that's the one I'm reading next.
00:38:30.000 --> 00:38:32.000
Nice, nice.
00:38:32.000 --> 00:38:33.000
So I just gotta say, I gotta put that out there publicly, I really like your recommendations. Yeah.
00:38:33.000 --> 00:38:40.000
Goodreads is my favourite social media. Yeah, it's my favourite– I’m also Sandra Milliken on Goodreads.
00:38:40.000 --> 00:38:50.000
You should follow her on Goodreads because I would say it's totally worth it.
00:38:50.000 --> 00:38:51.000
Yeah, oh man, I'm such a nerd. I honestly feel the best when I scroll through Goodreads and I've just like finished the book and like rated it highly, and then I see a couple of friends like add it to their like want to read list and I'm just like, am I an internet influencer? Like should I start getting monetized for this content? Like I don’t know.
00:39:05.000 --> 00:39:06.000
You should. That is a good feeling. Yeah, I really like that. I always get nervous when people– like I have a hard time recommending books to people because I don't know– same thing with music I get a little bit stuck in my hand about it.
00:39:06.000 --> 00:39:09.000
It’s so personal.
00:39:06.000 --> 00:39:09.000
Yeah, it's very personal. So it's Always a good feeling when someone–
00:39:09.000 --> 00:39:20.000
For sure. Yeah, I like all your books too.
00:39:09.000 --> 00:39:20.000
Thank you.
00:39:09.000 --> 00:39:20.000
Whenever you're reading a book, I'm like, oh, that's a banger, or she's gonna like love that.
00:39:21.000 --> 00:39:26.000
Yeah, yeah, you're the one that got me to do the– a couple of books that I've either finished reading or– and that– you just finished Remarkable– I forgot what it's called.
00:39:34.000 --> 00:39:35.000
Remarkably Great Creatures?
00:39:34.000 --> 00:39:35.000
Yes, that was a cute one. I like that one.
00:39:35.000 --> 00:39:40.000
Yeah But the, oh man, delightful, little octopus.
00:39:35.000 --> 00:39:40.000
Delightful is a very good way of putting that. I like that book a lot.
00:39:35.000 --> 00:39:40.000
Yeah. Yeah, yeah, I really enjoyed it.
00:39:41.000 --> 00:39:45.000
The first half was a little bit slower and then it just like, really got going and I was like, only notes is: needs more octopus. That’s all I gotta say.
00:39:45.000 --> 00:39:49.000
Agreed. Yeah, I agree. That was so cute. I really liked it. Oh, thank you so much. I'm gonna end the meeting– Or not the meeting– end the recording, I always forget to say this before I do the hit record, but, thank you so much for being here and I will talk to you soon.
00:39:50.000 --> 00:39:55.000
Yeah, take care.
00:00:01.000 --> 00:00:15.000
I loved that talk. I am stoked to be talking about some of the stuff on my podcast because for a lot of my life, this stuff felt like kind of taboo. I kind of alluded to having to deal with having the HPV vaccine and having gotten HPV under not good circumstances, and there's so many years of my life where It felt– like I felt so much shame around it and even with a menstrual health one, like I didn't know that periods like don't have to be painful. And never even thought to advocate for myself until later on in life. So I mean, that's a little bit more of a complicated thing as we discussed in the episode, but I'm just really excited that we're– To be having this stuff on the podcast, soI really hope that you enjoy it just as much as me, maybe even more. If you have any feedback, any questions for future episodes, for Sandra, we can chat about it in our next episode, you can send them to info@movewithbillie.com. That's B-I-L-L-I-E, no “Y” in there. You can also follow me on Instagram, Facebook, and TikTok at Move with Billie, same spelling. B-I-L-L-I-E. If you're gonna do anything though, following me anywhere, I would sign up for my newsletter because that is the most reliable place to chat with me get in contact with me, plus you get a lot of freebies. Before we head off, I want to take a second and let you know, I'm an ambassador now for Offering Tree. The website that hosts my website. Is that how you say it? The place my website’s through. And I love it because it has a little bit of everything, like you can do your newsletter through there, you can put your on-demand stuff up there, you can do scheduling through there, and personally love it. I'm not being paid to say this like I'm not sponsored by them. However, I do get a little bit of money if you use my link and you get money off– you get a discount, I get a little bit of money, it's a win-win so you can check out the link in the show notes or in my Linktree. I think it's Billie Smith is the Linktree. I mean it's linked below, I don't know why I'm telling you this but– the other thing is if you want to support me in the work that I do for this podcast, cause I don't know if you know, but I actually do not get paid for this part of my work, all of this is free. I don't– I'm not sponsored or anything like that, I don't make money. But if you want to support me, you can buy me a coffee, link in the show notes, I think you can do just like $2, $5, that kind of thing. Super appreciated. Really means a lot to me. I also want to take a second and thank Alyce who is my wonderful person doing the transcript now, I'm so stoked about this and I just really appreciate Alyce, so thank you so much for existing and being a part of my business. And I will catch you next week! Thanks. Bye!
