Creativity & Chronic Pain:
My Journey with Endometriosis

I draw a lot of birds. If this is your first time on my website, it’s not hard to tell that I am an avid birder and enjoy drawing the little creatures. I often draw them round, and sometimes they have little hats. Beyond birds, I love to draw all sorts of animals, and I have a special place in my heart for retro Toronto. I blame my obsession with Archie comics growing up. 

Based on the subject matter of my artwork, it may come as a surprise that most of my recent illustration and design work has been created during often debilitating pain flare-ups. 

Last week, I was told I have endometriosis. This ended the quest for diagnosis that I had been on for the past three years, trying to find an answer for my chronic pain. What began as incredibly painful periods when I was a teenager slowly devolved into pelvic pain that strayed outside my usual time of the month, becoming near-constant. For a long time I chalked this up to so many other things: maybe I had IBS, maybe it was just stress, my anxiety, my cross to bear. My mom had had really painful periods. Maybe it was hereditary. Maybe it was just the card I had been dealt.

In high school, I would miss one or two days of class each month, if not more, because of my cramps. I would get these awful period-like cramps in gym class all the time (even though I was a student-athlete and an active kid) to the point of throwing up on occasion. In college, my workload was so heavy that I could not afford to miss class, and I was prescribed opioid painkillers to numb my pain so I could go in. Things grew steadily worse as I got older, and I have a vivid memory of May 2020, when I lived in Vancouver, waking up one morning at 5am to pain so bad I called my mom (in Ontario) and told her I thought I was going to die and maybe I should go to the hospital.

After that incident, there was an interlude as I tried to launch my career, moving back home to Ontario. In 2021 I was dealing with some pretty major mental health issues (but that’s a whole separate post), so I put the whole “why are my periods so bad?” thought on the backburner. I did eventually start birth control in 2022, but it made me feel awful, so I asked for a referral to see an OBGYN. I spoke to my friends about their periods, but no one had similar experiences to me. Some talked about PCOS, but their symptoms didn’t match mine. So what was it?

 

Building a habit

During the COVID lockdowns, I borrowed a Wacom Cintiq tablet from my university lab and drew almost every night after I logged out of virtual school for the day. It was an incredibly stressful time, a time I’d rather not think about, but one of the best things to come out of being stuck in my shoebox-sized Vancouver apartment was the habit I built around drawing. I am a graphic designer first and an illustrator second, but the near-daily habit of drawing after class, usually while on a voice call with friends watching movies or a show (I binged Better Call Saul maybe three or four times that year), set me up for success as my health rapidly changed. 

I, like many people in Ontario, waited several months to see my OBGYN for the first time. And like clockwork, every month, my period would punch me in the gut and bring me to tears. When I finally met with my OBGYN for the first time in 2023, he floated around the word ‘endometriosis’, and said I should consider an IUD, as they can help with endo symptoms. I went for imaging to ensure that I didn’t have a cyst, and finally agreed to get the IUD, as it was covered by my employer’s insurance. I can pretty much pinpoint this as when things got worse for me. I, like many others, did not make a good match with my IUD. It gave me grief and added pain instead of removing it, so I lasted less than a year with it. When I had it taken out the relief was so instaneous that I wished I’d done it a lot sooner. (Of course, many people have had great success with IUDs so it really depends on your body!)

Even after the removal of the IUD, though, my pain continued. Some days I was so bloated that I looked pregnant, and as I was already struggling with my body image due to weight gain, it made me miserable. I didn’t know when my pain would strike, and it showed up seemingly at random, sometimes in the middle of my rec hockey games, sometimes when I was simply sitting for too long, sometimes for no reason at all. If I had more than a couple days strung together where I didn’t have a flare, I would start to get suspicious, waiting for the pain to pounce on me.

I shed a lot of tears over my body in the last few years. I took more time off my admin day job (a position I have kept primarily because of my struggle to find a job in the creative field, as well as its generous leave and medical benefits) than I would care to remember for appointments and days I just plain couldn’t get out of bed. I felt like I was losing myself. My friends were reaching milestones while I was reaching for my NSAIDs. Pain became my most constant companion, something that I had never thought would be my life in my mid-twenties. So, like many creatives, I did the only thing I could bear to do – I turned to my craft. 

Illustration became a distraction, a relief, something that I had control over. When I had absolutely no idea when pain would strike, I at least knew I could mould something with my hands, creating art that brought me joy and comfort when I often felt so uncomfortable. Even now, as I’m writing this post, I am just over a week post-op and my back is aching, but I wanted to write this as a way to get this all off of my chest. 

In 2024, I started hormonal therapy to see if it would help my then-suspected endometriosis. It was one of the treatment options I could only commit to because the medication was covered by my employer’s insurance, otherwise it would have been around $500/month out-of-pocket as it was not covered by OHIP. I found myself in what was essentially a medically-induced menopause, experiencing it right alongside many of my middle-aged coworkers. It made me feel awful. And worst of all, it didn’t help my pain. Finally, after exhausting all my non-invasive options, we decided to plan for a laparoscopic surgery. This is how endometriosis is usually diagnosed, and if it is found, it can be treated at the same time. So last week, I finally had my surgery, and sure enough, my doctor found endo. We had an answer to what has been causing me so much grief for so long.

 

 

 

 

 

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A post shared by Shruti Shivaramakrishnan (@chronicallymeh)

After diagnosis, what next?

It has been a lonely journey. But my creative endeavours, whether they are my illustration work, my love of creative writing (I’ve been working on a novel since 2020 that has singlehandedly made me want to pull my hair out but also brought me a lot of comfort), or my professional graphic design work, have all helped me find joy and make time for doing what I love, even if I have had to adapt my approaches for my own physical comfort. (Thank you iPad for letting me draw while lying in bed on my heatpad surrounded by 10000 pillows). Being able to make things with my own hands gave me the control I needed when I felt out of control of my own body, which did not like to cooperate with me, throwing fits often for no reason at all. 

Now that I have a concrete diagnosis, I can make plans for long-term management of this disease. Endometriosis is more common than one might think, though difficult to diagnose. Many diagnoses can take up to a decade. On that front, I am lucky that my active search for a diagnosis only took a few years. 

These past few years have definitely been two sides of a coin. On the one side, 2024 was my most successful year yet as a small-business owner, from building out my freelance design clientbase, to exhibiting for the first time at the One of A Kind Show in Toronto, to being nominated for my city’s Emerging Multimedia Artist Award, to signing my first big illustration contract, or even the two weeks I spent exploring Scotland with my elder brother where we ate haggis, climbed all through the Highlands, binged Kitchen Nightmares and I drank looots of Irn Bru. On the other hand, I ended up with discolouration on my stomach from constant hot water bottle usage and chronic low back pain from pelvic floor tension, I used up all my leave attending my doctor’s and ongoing physio appointments, I had numerous job rejections pile up, and I probably cried more tears of frustration than any year before.

My ever-changing health has made me more cognizant of accessibility, both in physical and virtual spaces. I have been blessed with a supportive family and group of friends, who understand that with chronic illness every day is different. Even my coworkers and clients gave me a lot of grace as I worked through my diagnosis journey. I’m grateful for my support system, everyone right down to the wonderful group of women I play hockey with who have looked after me no-questions-asked. It still feels strange to say that I have a chronic illness, but I am learning to embrace it and advocate for it. I believe now that my pain has a name, that things are looking up – I can plan. I have my control back. And no matter what, I know I can always create.

If my symptoms sound similar to yours, please check out The Endometriosis Network Canada for some great resources about the disease and its treatments.