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My Venetian glass perfume decanter
It is 33 years since I carried this little gem from Venice, Italy and through six more countries for another six weeks and then 16,531 kms back from London to Brisbane. This is a fragile, Venetian glass vase (well, perfume decanter) – of that there is no doubt. I bought it because it was/is beautiful and because on my first trip overseas, shopping was way too high a priority. As I have got older, I have realised what matters when you travel is the experience, the memories of the amazing food and to relish every image you create (on your iPhone) and imprint it on your brain so you can draw on it in moments of happiness, sadness, creativity, boredom or planning for the next trip.
I can still remember the anxiety each night, as I opened my suitcase to check that it had survived the rigours of the day. And I can intensely remember the triumph of getting it into our house in one piece – it was/is after all, a fragile Venetian glass vase (perfume decanter). Of that there is no doubt.
Sometimes women suffer pain in their vagina. It can hurt when they first try a tampon; it can be excruciating when they first have sex and there is nothing more devastating than when that pain only intensifies as the days, months and sadly, years go on. The pain can come on when there has been no pain before; for different reasons such as following a thrush infection, following gynae repair surgery, due to endometriosis or for no apparent reason.
For these women the vagina feels fragile – fragile like a Venetian glass vase.
Education is the cornerstone of persistent pain treatment. Pain science, which really we can no longer say is new, is well-researched and has the evidence base to ensure that it should be the first port of call when dealing with chronic pain. As mentioned in a previous blog, Melzack and Wall started this conversation on 1965. It is now 2017 – 52 years since that seminal paper. Since 2003, Butler and Moseley have Explain(ed) Pain brilliantly – so well, they have helped transform the lives of millions of people in pain around the world through their followers – physios, psychologists, OT’s, doctors and many other health professionals – who have joined their tribe of converts to the EP model of treatment for persistent pain and been able to change patients’ lives through education.
It can be a hard concept to accept. Every day, women say it’s hard to get their heads around, but adapting the EP model to pelvic pain does work (as well as treating any peripheral issues that will contribute to their pain).
An important part of my education of women with painful vaginas, is to explain that the vagina is not like a Venetian glass vase – it is, in fact very robust. 
The vagina, when aroused, can tolerate vigorous sex for a long time; and the vagina can deliver babies.
The vagina is very robust.
Many women relate to this image of fragility, when I ask them. When you have pain in your vagina, as each day moves forward, you have sought lots of treatment and nothing has improved – it just tends to get worse – this reinforces the belief and adds to the perception in your mind that the vagina is fragile.  As fragile as a Venetian glass vase.
But they especially like the new way to frame their thoughts on their vagina.
If we as health professionals can use language to transfer different meanings, different perceptions to the patient, then we are starting a different conversation about the vagina for that patient.
The vagina can be very robust – that is the new thought for the patient’s brain. 
When speaking of images and travel – look out for this new image below that will live imprinted in my brain after my next trip to Venice in September, on my way to the International Continence Society Conference in Florence from September 12-15th. The early-bird prices for this conference closes in two weeks, so make sure you check out the link and register asap. I am an ambassador for ICS and if you do decide to go based on this informative blog :-), don’t forget to mention my name when you are asked how you heard about the conference. (Thank you in advance!)
But the next photo you will see of this amazing sculpture called Support, by Lorenzo Quinn, depicting the effects of global warming on Venice in future years, will have me somewhere in the background.

Support by Lorenzo Quinn, Art Biennale, Venice 2017
(Climate change is real Mr President)