Hello June

Here are two blogs that I had stored in my Google Keep. They're not directly related, but what they have in common is that I didn't have time to type them out. They were all dictated using a voice-keyboard. Mostly while walking. I decided that when I got done with teaching I would subject myself to a health gauntlet and visit all the doctors that I had been procrastinating. I was confident that I would be able to convince someone to prescribe me some hormone replacement therapy (HRT). But I was unsuccessful. 

Here's what the doctor sent me. https://www.medicalnewstoday.com/articles/322587

And here's what I sent back:

High cholesterol (even with fasting) and pruritus (hands, feet, and vulvar) together are perimenopause symptoms. I don't want to ignore the cholesterol issue, which concerns me. Additionally, mood swings have been severe with unexplained crying mid-cycle and 10-days of PMS now.

I have been using Ultimate Hydration Body Cream for my hands and feet, which was one of your suggestions. I've tried Bounce Back Muscle Recovery Body Butter for my legs, sometimes a lotion with cooling menthol can distract my mind from the itching long enough to fall asleep. I have tried aloe vera aftersun with lidocaine, which does not seem to help. I have even tried Moisturizing Coconut Shea Butter Lotion on my vulva when it gets bad. It's so hard to sleep when I can't get any relief.

Yes, antihistamine diphenhydramine HCl at 50 mg does help, but I worry about its long-term side effects. It carries a risk of dependence, and I am 4321 days sober as of today (one day at a time). I don't want to rely on anything that can lead to dependency. This information is relevant to my concerns.

I'm not sure which type of Estroven is recommended; several types exist. I cannot see how much black cohosh is in each tablet. A review article suggests taking up to 120 mg of the drug/day, which is actually three tablets. Some studies showed that black cohosh increased HDL and lowered LDL, but not all studies showed this. More studies showed that black cohosh had no effect on cholesterol.

Now here are some more thoughts that I didn't share with the doctor:

Since meeting with my GP, I started taking a Menopause formula as a daily multivitamin. It contains soy isoflavones. How much of that is recommended for a daily allowance of isoflavones? Is there a danger of overdose? Will these new supplements together help regulate my symptoms? I don't have time to look into all these things! 

How much calcium is too much calcium? Should I add a fish oil supplement? If black cohosh has efficacy comparable to low-dose transdermal estradiol, why can't I take estradiol instead? It seems more prudent to take regulated substances instead of botanicals not regulated by the FDA. Estradiol plus intermittent micronized progesterone had a significant impact on LDL cholesterol.

And furthermore, can we trust the government right now anyway? Why is our country being run by influencers and funding is being slashed for women's health initiatives? We can't win right now! It was a very heavy Month of Mama this year. With my units being cut at CSUN, I can't afford to hire an outside doctor right now and pay for hormones out of pocket.

Mother's Day Musings

I feel like as women we are taught to accept less. To do more with less. To work with scarcity. And create magic. And that's how we are incrementally left with nothing. The gift we want is to be left alone. We're so tired of creating all the magic for others. 

I am dictating this while wearing a bra that I bought 6 years ago that's totally falling apart. It doesn't fit well. It's not supportive. This should be totally unacceptable. Why is it that advertising can make such big promises? But in the end most garments don't even do the bare minimum in terms of fit and function. 

I was doing so well in my Motherhood Maternity era, both during pregnancy and early Postpartum. In my Kindred Bravely era. In my Latched Mama era. In my LuLaRoe era. My Levi's jeggings era. Now that I'm in my Sweatpants era, I really don't give a crap about how other people perceive me in terms of what I'm wearing. Melani Sanders or “justbeingmelani” Instagram started a WDNC club. I appreciate what I learned during my Sarah Wells era and my Ceres Chill era. And I'm ready for whatever is next.

You don't matter

What I hear the medical establishment saying to me right now is your pain is not real. You're suffering is insignificant. Your problems are imaginary. This is what people have dealt with for thousands of years. We don't care about you. We don't care that you're suffering. We do not care that your life is impacted. We do not care that you're not able to sleep. We don't care about your history of substance abuse. We don't care to actually help you. We don't think you matter enough to focus on your problem. Your contributions to society are insignificant or are largely in the past. You do not have enough value to warrant our attention.

We will address each of your symptoms as individual problems, not look at the total sum of what these clues point to. We are going to dismiss your concerns one at a time, chalk it up to a lack of healthy diet, a lack of exercise, and simply a family history of high cholesterol. We're not going to look at the bigger picture and say that this is a new problem that has arisen in the last 5 years. We're going to say that your numbers are borderline anyway, therefore no action is required.

At what time do you realize you aren't going to be able to fall asleep? At what point do you cancel tomorrow's workout? When do you shut off the alarm you had set for tomorrow? At what point do you realize it's too hot in your bedroom? At what point do you start googling symptoms? At what point do you lean into online providers and telehealth? At what point do you give up? I don't want to be the person who has given up on myself. I want to keep moving forward. I want to realize I am only at midlife. I have 45 more years to go. Family tree roots run deep.

References

C. Castelo-Branco, M. Gambacciani, A. Cano, M. J. Minkin, D. Rachoń, X. Ruan, A.-M. Beer, J. Schnitker, H.-H. Henneicke-von Zepelin & S. Pickartz (2021) Review & meta-analysis: isopropanolic black cohosh extract iCR for menopausal symptoms – an update on the evidence, Climacteric, 24:2, 109-119, DOI: 10.1080/13697137.2020.1820477

Gordon JL, Rubinow DR, Watkins L, Hinderliter AL, Caughey MC, Girdler SS. The Effect of Perimenopausal Transdermal Estradiol and Micronized Progesterone on Markers of Risk for Arterial Disease. J Clin Endocrinol Metab. 2020 May 1;105(5):e2050–60. doi: 10.1210/clinem/dgz262.

On the plus side, I got results back from the pap smear (normal), the mammogram (normal), and the bone density scan (normal). I got a new eyeglass prescription but there has been a delay. The glasses should be ready for me to pick up in a few days. I am still waiting on the referral for colonoscopy.