You’re NOT Going Crazy!

During this season of hormonal changes and physical symptoms, I’ve been able to commiserate with a couple of unlikely young women experiencing adjustments of their own.  My daughter is almost three months pregnant and my daughter-in-law is four and half months along.    It’s interesting to me that we share many similar symptoms:  indigestion, fatigue, nausea, foggy brain, memory lapses, moodiness, and the ever expanding waistline.   The one glaring difference of course, is that my personal journey will not result in a new baby! (And yes – I’m sure.  A negative pregnancy test taken one week ago proves it!)  Part of the personal perks of this season of life includes the blessing of grandchildren; part of the challenge is learning to adjust to the hormonal storms that come and go without warning.

Those of us who have been pregnant and experienced labor and delivery know that every woman’s experience is incredibly different.  I have a friend whose first labor was 36 hours.  Mine was 45 minutes.  (Totally not fair, I know.) Because every woman is different, their experience of perimenopause and menopause will also be different.  Some women begin to experience perimenopausal symptoms in their 30s, some sail right on through the hormonal adjustments of menopause without even breaking a sweat.  (I’m not jealous – Ok, maybe a little bit.)  As soon as I think I’ve experienced every possible symptom known to woman-kind, a new one shows up on the horizon and I’m forced to find new grace to adapt.   I think the hardest part of this whole season is the unpredictability – I don’t like surprises.  Like most women, I prefer a little more control over life.  Some menopausal women report feeling like they’re going crazy and although some of that sense may be directly attributed to the very real hormonal changes occurring internally, I also believe it may be related, quite simply, to that feeling of the loss of control. Let me assure you: You’re NOT going crazy.  Similar to labor and delivery, we’re just going through a natural process of change that is not the end, but actually the threshold of a new life adventure.   Just breathe.

Someone came up with a list of 35 perimenopausal symptoms.   I find it incredibly comforting to know that some new, weird symptom I’m having might be something other sisters have experienced before me, thus making me “normal…ish”.  Knowing that my sore tongue, for instance, might NOT be some exotic incurable disease, but actually be indicative of this lovely change of life helps me breathe a little easier and find some peace to go with the flow.   

About a month ago, my ears suddenly started ringing.  It was loud, obnoxious, unrelenting and rather disconcerting and what’s more – it’s still going on.   I went to the chiropractor to have my neck adjusted, hoping for some relief, but alas, that didn’t do the trick. And then I checked the 35-symptom list.  Guess what is the 35^th symptom?  Yep – that’s right: ear ringing.  Can you believe it?  I have no idea what is the physiologic reason behind the ear ringing but as with many other things happening in life right now, I just chock it up to the same overarching troublemaker: hormones.  (By the way, I experienced ear ringing during the birth of my first child as well.  Hmmm…Interesting.)

So, here’s the list.  Personally, I have experienced as many as 26 of those listed below.  How about you?

1.     Hot flashes, flushes, night sweats and/or cold flashes, clammy feeling

2.     Irregular heart beat

3.     Irritability

4.     Mood swings, sudden tears

5.     Trouble sleeping through the night (with or without night sweats)

6.     Irregular periods; shorter, lighter periods; heavier periods, flooding; phantom periods, shorter cycles, longer cycles

7.     Loss of libido

8.     Dry vagina

9.     Crashing fatigue

10.  Anxiety, feeling ill at ease

11.  Feelings of dread, apprehension, doom

12.  Difficulty concentrating, disorientation, mental confusion

13.  Disturbing memory lapses

14.  Incontinence, especially upon sneezing, laughing; urge incontinence

15.  Itchy, crawly skin

16.  Aching, sore joints, muscles and tendons

17.  Increased tension in muscles

18.  Breast tenderness

19.  Headache change: increase or decrease

20.  Gastrointestinal distress, indigestion, flatulence, gas pain, nausea

21.  Sudden bouts of bloat

22.  Depression 

23.  Exacerbation of existing conditions

24.  Increase in allergies

25.  Weight gain

26.  Hair loss or thinning, head, pubic, or whole body; increase in facial hair

27.  Dizziness, light-headedness, episodes of loss of balance

28.  Changes in body odor

29.  Electric shock sensation under the skin and in the head

30.  Tingling in the extremities

31.  Gum problems, increased bleeding

32.  Burning tongue, burning roof of mouth, bad taste in mouth, change in breath odor

33.  Osteoporosis (after several years)

34.  Changes in fingernails: softer, crack or break easier

35.  Tinnitus: ringing in ears, bells, 'whooshing,' buzzing etc.


 

Crashing Fatigue

“Hi. How are you feeling?”

Over the course of the past year, I wonder just how many times I’ve responded to that question with this one word: “Tired.” 

I have friends who will now answer it for me.  “How are you? Wait. I know. You’re tired, right?”  Yawn. “Right.”  

Truth is, “Tired” doesn’t quite cover it, but if I were to respond with the unabridged accurate answer, I might fall asleep mid-sentence.  Plus, it would make me sound whiney and I hate sounding like a whiney 50-year-old.   

“Hi. How are you feeling?”

“I feel like an exhausted zombie with serious jet lag who overdosed on Benadryl.  I’m so overwhelmingly tired, I can’t think or see straight and I am at serious risk of walking into a wall, collapsing into a heap on the floor. (Which may work as a nice place to nap. Don’t tempt me.)”    

“Crashing Fatigue” – that’s the official perimenopausal term for this prevalent symptom of the middle-aged woman.  I find it to be such a satisfying phrase, don’t you?   Crashing Fatigue.  It’s not just tired, or sleepy or even exhausted.  No - I’ve actually crashed.  Run out of gas and collapsed. Get the paddles charged and call “clear” because that’s the only way this girl’s getting revived.   What’s more, this sudden attack of exhaustion can hit at ANY time of the day!  You can be assured however; this symptom will rarely hit you at night time. (That’s when insomnia comes to visit.)

You may assume that your exhaustion is a direct result of the lack of sleep you acquired last night, and whereas, that may play a part in your level of tiredness, there is actually more at work in your body which may be causing you to feel more tired than is reasonable.  Another phrase used for this particular symptom is “Adrenal Fatigue.” Without forcing you to re-live the horrors of Biology class, let me just comment on the basics. Your adrenal glands are two small endocrine organs that sit atop your kidneys and their primary responsibility is to release necessary hormones that help you deal with the stressors of life.  Typically, this works well for most of us, however, during these years of change, estrogen begins to play a huge role on the effectiveness of those adrenal hormones.  It’s almost as if estrogen is busy cancelling out helpful hormones that typically give us energy to do the stuff of life.  Bottom line: Your body feels like its run a marathon just after pushing a piano up hill, when in reality all you did was make a pot of coffee and throw a load of laundry in the washing machine. 

Now, consider how a woman might feel who experiences crashing fatigue, insomnia, hot flashes, mood swings, and internal changes she did not instigate.  I’m thinking she might be a little cranky from time to time.  (I think my husband would concur!)  Some of the suggested treatments for management of hot flashes, may also help with crashing fatigue – particularly those that target estrogen or progesterone levels.   Besides that, here are a few other suggestions:

·         Try to get at least 8 hours of sleep at night

·         Be sure that your night-time environment is conducive to sleep. (dark, quiet, etc.)

·         Deep Massage may help you relax, as well as help balance those helpful adrenal hormones.

·         Eat a HEALTHY diet, including energy-boosting snacks as needed:

Include vitamin C, Bs, and iron (as anemia can cause add to your tiredness)

·         A 20 minute power nap is often all it takes to rev up your engine again, giving you enough energy to keep going.  At least until the next napping opportunity.  

·         Exercise but don’t over exert!

If fatigue feels like it’s dragging on from days into weeks, it may be time to consult with your physician as more may be going on.  Generally speaking however, as with the rest of the perimenopausal symptoms, you will return to some semblance of “normal” once your hormones find balance again.   In the meantime – take time to relax, read a book, take a nap, and don’t worry too much about what’s not getting done.

Rest assured - It’ll all be there when you wake up. 

And now...I'm thinking it's time for a nap.  G'night, Friends!

Hot Mama

Can you guess what is the number one menopausal symptom for North American women?  That’s right – Hot flashes. (Also known as hot flushes, warm flashes, night sweats, slow embers, and infernal internal inferno. Ok, maybe I made that last one up.)  It’s interesting that 80-90% of American women reportedly deal with hot flashes during those middle-age years, while our sisters in India and Asia hardly ever break a sweat.  Another interesting bit of trivia – Did you know that we will observe “World Menopause Day 2012” this coming Thursday?!  A whole day dedicated to menopause.  I don’t know how you plan on celebrating, but as for me, I have a GYN appointment at 1 PM to commemorate this auspicious occasion!  Woo hoo.   

I read a statement made by the president of the International Menopause Society (IMS) that you might find encouraging if you feel like you’re suffering in silence, trying to just grin and bear it: “Too often the distressing symptoms associated with the menopause (yes…”THE” menopause) are not taken seriously enough... A woman can’t just “grin and bear it” – if only it were that simple…For most women there are ways of overcoming these problems, and a woman going through a difficult menopause should make sure that she talks this over with her doctor to find the best solution for her.”  I take comfort in the fact that people understand that these symptoms can be distracting and sometimes disruptive to our lives.  I’m also glad to know that there actually may be appropriate ways to deal with these crazy manifestations! 

So – what is a hot flash any way?  According to the Mayo Clinic, hot flashes are sudden feelings of warmth, which are usually most intense over the face, neck and chest.  Some women appear to blush in their cheeks, and some begin to sweat profusely, or start shaking with chills.  As with many of the peculiarities of the human condition, no one is absolutely sure what happens physiologically inside the woman’s body to produce these waves of heat, however, many agree that it probably has something to do with a shift in estrogen which then interferes with the functioning of the “thermostat”. (the hypothalamus – an area located at the base of your brain.)   Quite often, a woman’s core temperature actually rises by a degree or two during a hot flash.   Hot flashes typically last between 2-4 minutes although some report feeling extra warm for up to a half hour.  (These are called slow embers.)   Many women struggle with them for a couple years prior to menopause and some continue to have warm flashes even well past the onset of menopause.
  

In preparation for the writing of this post, I had two hot flashes today.  I didn’t CHOOSE to have these hot flashes, mind you, but rather they chose me.  As with the insomnia of last week, I am choosing to redeem the event by writing about it and sharing it with you!  

It’s hard to know how to dress for a hot flash day, not that I ever know when they’re going to hit.  I find it especially challenging during autumn, when outside temperatures are so very unpredictable.   These days, I often dress in layers: tank or T-shirt, a blouse over top of that, a sweater on top of that and today – a lovely Italian neck scarf.  On my way to church, I stepped outdoors to temps in the 60s and did pretty well all morning, that is, until I lingered in conversation with a friend after the service concluded.   There she was, sharing with me the details of her life and I’m tracking pretty well until the heat hits me.  Whoosh!  Whoa – I pull off my stylish scarf and grab the back of a chair because although I’m not at all dizzy, I feel a little thrown off by the overwhelming attack of fire that originates from deep within my core and I am completely distracted.   Not wanting to be rude, I politely nod as my friend continues with her story although I confess, I’m only truly hearing about every fifth word.  “…home…car…time…see...” to which I reply with a smile, “Good, good.”  A second later I realize in horror that she was talking about someone involved in a car accident.  Oops – now I’m red in the face for a completely different reason. 

The intensity of this hot flash lasts for no more than 2-4 minutes, but I continue to feel warmish for a while longer before another heat wave hits.  I wish I could just close my eyes and pretend I’m on a summertime beach vacation but it doesn’t work that way.  Hot flashes are stifling, disorienting, overwhelming and terribly unpleasant.  My heart races in response. Ugh. I hop in the car and blast the air conditioner on high – apologies to my son, who has to share my arctic air space for the ride home.  Once home, I race upstairs to get into my summer clothes and relax outside for much of the afternoon, enjoying the refreshing breeze.  Ahhh, to be normal again.  

Dealing with the Hot Flash Intrusion

There is hope!  Although there is no treatment to completely remove the incidence of hot flashes, there are many quality recommendations to help us deal with them.  Below is a list of helpful hints and treatments for your consideration. 

Dress in layers

Avoid heated environments

Avoid stress and promote relaxation (women with anxiety are at significant increased risk of suffering from intense and frequent hot flashes.)

Avoid smoking, caffeine, alcohol, and spicy foods.

Drink iced beverages

Focused deep abdominal breathing for 15 minutes twice a day.

Exercise (this is on every healthy list known to man)

Climb into your chest freezer (this is a joke. Please do NOT climb into your chest freezer no matter how tempted you are!)

Eat a Healthy diet

Air conditioner/fan

Flaxseed (some discrepancy of its effectiveness)

Soy (some discrepancy of its effectiveness)

Vitamin B Complex and Vitamin E

Black Cohosh

Natural Progesterone Cream

Hormone Replacement Therapy (there are some medical risks)

Anti-depressants such as Zoloft (Selective Serotonin Reuptake Inhibitors)

Gabapentin  (A drug typically used to treat headaches)

If you’re considering trying any of the suggestions on the lower list, you will want to be sure to consult with your physician.  I hope you’re able to find the solutions that work for you.   As always – if you have a secret remedy that has worked for you, by all means, please share your thoughts!  We are in this together and some of your sisters are currently wiping their sweaty brows and fanning there flushed faces, longing for a reprieve.

And now may God Almighty grant you air conditioning in your hour of need. 

Sleepless Beauty

It seems fitting that I would write this post at 2 AM.  I got ready for bed, read for a little while, turned out the light and drifted off to…nope.  Nice try but it’s not happening.    I understand that sleeplessness is one of the most common of all the perimenopausal symptoms and I’m happy to say that, with the exception of tonight, I have generally not had to deal with this one very often.  Nonetheless – here I am – not sleeping.  

It’s maddening when you think about it.  The alarm goes off too early in the morning.  You hit the snooze.  Once. Twice.  Three times.  Pretty soon, you lose count – that’s how you know it’s time to get up.  You race to get ready and get busy about your day.  Not only do you tackle the things you knew were on your agenda, but you are also faced with the challenge of dealing with several non-scheduled “emergencies” as well.  By mid-afternoon you’re exhausted and looking for a cup of coffee but you resist, knowing it will likely keep you awake several hours later.  You plow through the afternoon, barely getting supper together before you crash on the couch for a little down time.  You can hardly keep your eyes open and finally, you drag yourself upstairs to bed and gratefully collapse on your pillow-top mattress.   You turn out the lights, snuggle into your pillow and hmmm…

“Did I turn out the bathroom light? Is the cat out?  I should get some milk tomorrow.  I wonder if the bank will be open.  I think it’s going to be cold out – maybe I should check the weather. Why am I not sleeping?  I thought I was exhausted.  I feel hot. What’s wrong with me?  Maybe I should get up and stop wasting time trying to sleep.  That’s a bad idea.  On the other hand, I could write that blog about sleeplessness…”

Shifting hormones can mess with our sleep patterns, but nothing messes with it more than plain old worry.  Women our age are often carrying a boat-load of concerns.  Many of us have children who are not quite fully adults, but think they are – that alone will keep moms awake for hours!  In addition to that, we may have parents who have health concerns and jobs that keep us busy.  We have friends with difficult struggles, meals that need to be made, bills that need to be paid and our own crazy symptoms to deal with!  That’s a loaded list of things to think on when we’re trying desperately to fall asleep!   Perimenopause plus worry equals sleeplessness.   If we can try to remove the worry part of this equation, we increase our chances of sleeping at night. Sounds simple enough - but - how do we worry less?  Well, I guess we learn to trust more!  Philippians 4:6 & 7 gives us a helpful reminder about how to deal with our tendency towards worry:  “Be anxious for nothing, but in everything by prayer and supplication, with thanksgiving, let your requests be made known to God;  and the peace of God, which surpasses all understanding, will guard your hearts and minds through Christ Jesus.”   

Prayer is my go-to when I can’t sleep.   I’m not sure that makes me very spiritual though. After all, let’s be honest, I am using prayer like some sort of divine sleeping aid.  I don’t have to turn the light on, or get out of bed to accomplish this worthy activity.  I can lay right there, lazy as a log, ready in my sleep-position of choice, praying up a quiet storm and all the while prepared to drift off to dream land.   Sometimes it works and sometimes I find myself frustrated and praying an exasperated prayer, “GOD! Please help me go to sleep!  That’s why I came to you in the first place!”   

I have a smart phone that I keep next to my bed as it charges.  Tonight, while I lay there in the dark,  I Googled, “What to do when you can’t sleep.”  I was amused by the findings.  One of the options was to download the app for Jeopardy and work at getting smarter by building my trivia skills.  I was fine with the idea, until I found out that the Jeopardy app is $1.99 to download.  I don’t know about you, but I need to generally steer clear of spending any money at 2 am.  It’s rarely a good decision when you’re tired and menopausal. (This also stands true for QVC watchers.) 

What else can you do while awaiting a visit from Mr. Sandman? (Now that song came out WELL before my time, just to be clear. *See previous post.)   I have friends who tell me that they bake, watch old TV reruns, make crafts, read, organize old photos, iron, make their shopping list, and make vacation plans.  

You know what’s NOT on this list?  Counting sheep.  I’m not sure who came up with the idea that counting sheep was a valid sleep-inducing activity, but I have not found it very effective.  First of all, I have to wake myself up enough to actively imagine these pretend sheep so that I may count them-how’s that helpful?   Then of course, I am struck by the odd sight as I envision these imaginary sheep each able to bound over a small wooden fence with ease and grace.  These must be superhero sheep because I don’t believe (although I am no shepherd) that regular pudgy ones could ever clear more than 3 inches at best.   I’ve also never found sheep to be that orderly, have you?  Whenever I’ve attempted to count them to help me sleep, they start bunching up, trying to all climb the fence at once.  Some even try to crawl under it and several are butting each other out of the way.  Furthermore, their constant pretend baa-ing, which sounds so much like whining, completely distracts me from counting and I give up.  This is not at all restful for me!  I am not a farmer – and I have no interest in counting the heads of non-existent livestock at 2 AM!

As I said at the beginning of this post.  I’m relatively new to the whole world of sleepless nights, so my list of “What to do when you can’t sleep” is not at all exhaustive.  I suppose that I could check Google to get more ideas, but I would honestly love to hear what has worked for you.  So, to my bleary-eyed, night owl friends, tell me would you: what do YOU do in the wee hours of the night when sleep is not an option?   (And you lose points if you say, “Worry”.  But I’ll give you bonus points if you say, “Benadryl”). 

Ok – time for another attempt at sleep!