Some people in the blogging community are really good at remembering to follow up on things. I am not one of those people. It feels like I owe you (or Future Me, I suppose?) a few updates and I am in the mood to try to recall some of the many (many) things I have brought up/fretted about/whined about in this space and never mentioned again.
Brief Doctor Follow Up: Since my post, I have had two appointments with my new PCP and one appointment with my OB/GYN and two rounds of bloodwork. A.) I took everyone’s advice and brought a very short and tidy list with me to my appointment last month. B.) Despite The List, I suck a being a patient and an adequate advocate for myself. C.) All my bloodwork shows I am normal and healthy, which is fantastic. D.) It seems like the reason I am tired all the time boils down to “being a human” and the treatment is “suck it up.” (This is my interpretation, not my doctor’s actual words or demeanor.) My doctor did refer me to get a sleep study (scheduled for a few months out) so we’ll see if that shows anything, but I’m not holding my breath. (That was a sleep apnea pun.) (Sleep apnea is not funny.)
image from Reader’s Digest
Brief Gift Follow Up: You were so encouraging about my gift idea for my friend’s big birthday, I decided to rail against my tendency to continue fretting until it’s too late to do anything about it… and order the painting I had in mind. First, I asked my mom if she would be interested in painting the landscape for my friend (she is a very talented painter) and she declined, which I was sort of expecting. But I found an artist who hand-paints lovely landscapes (apparently lots of other people produce digital artworks, so the hand painting is clearly stated on her Etsy profile), sent her my reference photos, and the gift is ORDERED.
Brief Cat Follow Up: I spoke to the cat breeder I met two years ago at a cat show and she is going to put us on the list for the next litter.
Actual kitten not pictured.
Brief To-Do List Follow Up: I have scheduled my mammogram and sleep study. I have scheduled and attended an appointment with our accountant. A car service appointment is on the books. Yesterday morning, I made a phone call I have been dreading making since mid-December and instead of going the way I thought it would, it went just fine. I sent a boring email that was stressing me out. I finished reviewing a manual I am editing. Today, I need to make a new phone call, but I am going to do it today instead of four months from now.
Brief Poinsettia / Vacuum Follow Up: My monstrous poinsettia continues to flourish and continues to drip leaves all over my living room floor. Rocky continues to uncomplainingly do the work of one reluctant eleven-year-old and one irritated middle-aged woman and I continue to love him/it with my whole being. (I will say goodbye to the poinsettia before the kitten joins my household.)
Temporarily relocated for watering purposes.
Brief Gallery Wall Follow Up: There is still no gallery on the wall.
That’s all that comes to mind at the moment. Is there anything you’re waiting on tenterhooks to hear about? Do you have any updates for ME?
Why have my insurance plan and my annual schedule conspired to make January the month when I have All the Appointments? I was trying to make plans to write with a writing friend and I looked at the calendar and it is PACKED. I feel like January is nearly over and it has only just begun.
One of my upcoming appointments is with my OB/GYN, and I have been steeling myself to insist a little more forcefully that I believe I am in perimenopause. You will likely not recall that last year, my tentative questions about it were dismissed due to my age. The array of symptoms that seem to be perimenopause-related continues to grow, so I just want to confirm that a) yes, this is happening and b) there is nothing I can really DO about any of it, beyond what I am already doing. (TMI note: I take oral contraceptives which both prevent a period, so I don’t have that to clue me in as to actual menopause, and, according to the OB/GYN, oral contraceptives are supposedly the first line of defense against perimenopause symptoms anyway.) I had also been steeling myself to ask for a physical exam this year, should it be bewilderingly optional as it was last year, but I am pleasedI am relieved I see from last year’s post that I should expect a pap test this year so that shouldn’t be an issue.
The other upcoming appointment is with a new-to-me internist. I have been mildly fretting about the appointment for, oh, several months now. I am eager to have a primary care physician again; my last PCP, whom I adored, prescribed me a new medication two Decembers ago, then went on leave until March, then left her practice to become a concierge physician. I love her enough that I strongly considered following her to her new practice, but I did not. Anyway, I have ostensibly been without a PCP since December of 2023. The old practice has been kindly refilling my prescription all this time, but I will be relieved to have a regular doctor again. (Yes, it has taken me since approximately March of 2024 to get in to see a new physician. This is both because I wanted a doctor whose office is closer to where I live now and because I wanted the specific provider my husband recommended.)
The thing I am fretting about is that this appointment is about establishing me as a patient… but I also have A List of things to discuss with the doctor. So I am worrying both about coming across as someone the new doc wants to have as a patient… and about addressing my concerns.
Is the first fret ridiculous? Yes, yes it is. I can acknowledge that without being able to eliminate it from my worry database. I am sure this doctor sees a thousand middle-aged women just like me; I am not going to be any more or less desirable as a patient. Plus, physician’s job is to deal with the patient in front of them, not reject them based on some sort of Simon Cowellian checklist. (Is Simon Cowell still a contemporary reference?) And in any case, physicians treat patients all the time that they might not otherwise hang out with or befriend; we do not need to be besties.
STILL. I want to make a good first impression. That’s weird, right? And yet, there it is.
Let’s move on to the less-ridiculous portion of my frets, which is how to address all the things I want to address without overwhelming the doctor or myself, and without doing that thing where I make a careful list and then get to item three and suddenly feel like I’m overstaying my welcome or talking too much or whatever. I cannot tell you how many times I have gone to see a doctor with Very Specific Things To Discuss, and have decided in the moment that they are silly and I won’t bother the doctor with them. Even when I bring a written list with me, I still do this.
(You might think that having grown up with a physician for a parent, and then marrying a physician would negate some of the awkwardness I feel when at the doctor. But no.)
Since three seems to be the magic number, I think I have narrowed my Must Discuss List to three topics:
Fatigue. I am tired all the time. Like, more tired than in years past. (I feel like I’ve been chronically tired since at least 2012.) So tired that I see the effects of the tiredness in other areas of my life. Is this… The result of a medication I’m taking? A symptom of perimenopause? A deficiency of iron or vitamin D or something else? Because I am terrible at sleeping? Subset of the previous: it is because of my horrifically restless legs? Is the terrible sleeping a result of poor sleep hygiene? Or perimenopause? Or some lifestyle choice I am making? Is the tiredness (and/or terrible sleeping and/or restless legs) fixable? Or is this just my current phase of life (The Tired Phase) and I need to accept and lean into it?
Medication. I started taking anxiety medication in December 2023 after a series of escalating panic attacks. The medication has been very helpful. I think I am in a less anxious state now than I was then; is it time to try to discontinue the medication? If so, how do I do that? And what happens if I decide it was a terrible plan to discontinue it? Yes, 2023 was a wildly exciting and action-packed year which ended spiking my anxiety to new heights, but it’s not like I was NOT anxious before that. I am not opposed to taking medication when it is helpful, but I also don’t really want to take medication if I don’t need to.
Weight. Due to some fairly significant weight gain over the past year, I am heavier than I have ever been in my life. Aside from not being pleasant in a variety of ways for a variety of reasons, I am wondering if I need to Be Worried. Is my weight gain a side effect of the aforementioned anxiety medication? A symptom of perimenopause? The result of too many nachos? Something else? Is it causing any problems I should be aware of, aside from the expected and unwelcome not-fitting-into-my-clothing and poor-self-esteem issues? (Like perhaps my extreme tiredness?) Beyond trying to eat less and move my body more, is there anything I should be doing?
You may notice that this very tidy list of three contains many, many subtopics. That feels a little like cheating. (I imagine myself telling the new doctor, “I want to discuss three health concerns with you!” and then bombarding her with restless legs! and perimenopause symptoms! and anxiety! and insomnia! as she crumples to the floor under the weight of my hypochondria.) (Yes, I do realize this is not how doctors work.)
You may also notice that “weight” is at the bottom of the list, in case three topics ends up feeling like too many topics with which to burden the doctor. (I know; I cannot stop thinking this way.) I put it at the bottom because it is the topic that, to me, seems to have the most obvious solution (eat less and move your body more), and also because it is the topic that I feel least comfortable bringing up. It’s such an uncomfortable topic! And possibly the doctor will bring it up anyway, without me having to say anything.
I have a new, third fret: that I will inadvertently turn my New Patient Appointment into a Sick Visit. Why yes, this fret IS brought to you by two weeks of my family being sick plus waking up at four o’clock this morning with a terrible headache and a sore throat that feels worse than yesterday’s mildly scratchy throat and ear pain and a low-grade fever.
What happens if I AM sick for my appointment? Is that… allowed? I feel like the “rules,” insofar as I (don’t) understand them are that you can’t be treated by a new physician until you have established with them as a patient. This is why I have been scrupulously healthy this year, because I would much rather go see my PCP than visit urgent care.
If I AM sick for my appointment, then identifying/treating that illness probably jumps to the top of my list of concerns… but can I also address the other less-urgent topics?
Should I perhaps be badgering my husband with these questions instead of fretting about them on the internet? I mean, yes, but what is the internet for if not for airing ridiculous worries.
Boring But Hopeful Health Updates. I am going to say this very quietly, lest I jinx it: but I think that I can eat yogurt again? I have been avoiding dairy since May (which is not the same as giving it up; I still put half and half in my tea, I eat occasional sour cream and occasionally throw a dollop of yogurt onto stir fries and have had the occasional scoop of ice cream) after my acupuncturist suggested it might be negatively impacting my skin. My dermatologist was receptive to this idea and thought, based on some semi-related studies he’d read, that it could be exacerbating my rosacea. Based on some very non-scientific experimentation, it SEEMED true. There was a week when I ate white bean enchilada soup every day for lunch and my skin freaked out, for instance. And there is milk and yogurt in that soup (it is a fantastic soup), so I blamed the dairy. When I avoid dairy, I am mostly okay. I do also have to use a special face wash, though, so maybe that’s what’s keeping the bulk of the rosacea at bay. My family and I went on a weekend getaway recently and I decided to throw caution to the wind and eat some yogurt for breakfast every day. Nothing happened, skin wise. So when we got home from our mini-vacay, I continued to buy and eat yogurt. I have been doing it for several weeks now and things seem stable??? I am so hopeful about this, because I LOVE yogurt. It is delicious but it is also such a fantastic source of protein, especially since I dislike eggs.
My usual breakfast of late: SmartLite bread with almond butter and honey, yogurt, and tea.
Now I am whispering so softly my voice is but a rustle: my plantar fasciitis seems like it is under control??? I don’t know what happened or when, but my feet just feel… better??? I am continuing to wear shoes in the house and I do calf stretches every night before bed but… I haven’t been to the acupuncturist in two months and I don’t feel like I need to make another appointment.
Puzzling Gynecological Visit. While we’re on the topic of health, why not discuss my recent visit to the gyn? I did promise Ally some speculum content, but I am immediately going to break that promise because there was no speculum involved. This wasn’t the puzzling part; current gynecological guidelines recommend that most people with a uterus have a pap test every 3 years as part of a screening for cervical cancer, and I’m not due for a pap until next year. However, I was there for my yearly reproductive parts exam. In years past, this has included a pelvic exam, a breast exam, and a discussion of my health concerns. This year, the nurse got me situated in a room and asked if I would be okay having a resident take part in the exam.
The resident was lovely. Great bedside manner, seemed very knowledgeable about my questions (which were specific to breast cancer and perimenopause). She asked if I needed any prescriptions renewed (yes) and whether I wanted her to order a mammogram for me (yes). But then she finished the talking portion of the visit and said that the exam was optional. What????? OPTIONAL? I didn’t know what to do with that information! Listen, I think we’d be hard pressed to find anyone who ENJOYS a pelvic or breast exam. They are invasive and embarrassing and uncomfortable. But… the exam is the purpose of the annual gynecological well visit! If I just wanted a refill of birth control pills, I could simply call that in! I came to the office specifically so that the doctor could poke and prod my bits and tell me if anything was wrong!
What I should have said was, “Of course I want an exam, that’s why I’m here.” But I got flustered when the resident gave me the option. Part of me, I think, was a little embarrassed to ask that she examine me. Which is dumb, because that is her job, and, again, WHY I WAS THERE, but I still felt like it was weird to request it, if it was optional. So I said, “Well, what do you recommend?” And instead of saying, “I recommend you get your reproductive parts examined” she said, “It’s up to you.” WHAT?! That is not a recommendation. We hemmed and hawed a little bit, and finally I said something like, “Well, I came here prepared for a physical exam, so I might as well do it.” But the whole thing was weird and awkward.
And also: WHAT THE HELL? A) Why is the physical exam suddenly optional? And B) What is the point of the annual gynecological exam if there is no exam? The whole experience was baffling.
Speaking of Perimenopause. A ridiculous spate of hot flashes has had me in a bit of a fret about whether I am beginning perimenopause. Doesn’t seem likely, considering my family history, but who really knows, right? There is a fine line between The Normal Joys of Having a Female Reproductive System and going through The Change. The gynecological resident reassured me, if a little dismissively, that I am too young for perimenopause and then moving along to other topics. Maybe so (although I am 42, so it’s not wildly out of the realm of possibility), but it’s something I want to prepare myself for, so I’m thinking about it now. I am listening to Hot and Bothered: What No One Tells You About Menopause (and How to Feel Like Yourself Again)by Jancee Dunn so it’s top of mind. The book is engagingly written – I like Dunn’s energetic voice and humorous/informative writing style. It seems like she did her research, and there are tons of practical tips for how to address various symptoms of menopause. But the book makes me so uncomfortable! In some cases, the physical discomfort is so severe that I find myself squirming in my car. Dunn is careful to interject, not infrequently, that not every person will experience every symptom, that a lot of people go through menopause with nary a hot flash. But this book covers the whole spectrum of menopause issues, so the whole thing feels REALLY OMINOUS. Yikes.
Nature Is Healing. This is probably something I should say very quietly, as well, lest I scare it away, but it seems like sriracha is gradually making its way back into the world. Sriracha – specifically Huy Fong sriracha – is my favorite of all condiments. It would be one of my desert island foods, for SURE. I love it so very much. So I have been keeping an eye out for it in the years since its production has dwindled and have built myself a little stockpile. (There was a moment when I got down to one bottle and tried a bunch of alternatives to see if there was something else I could live with. No, there isn’t. So I have gradually replenished my stores.) I’ve almost always been able to get it on Amazon, although there were a few months this past spring when it was unavailable except for ridiculous prices. (Will I pay $17 per 14-ounce bottle? Yes, it turns out, I will, but that’s pretty much my limit.) But then I noticed it was readily available in Asian grocery stores. I made myself a deal that if I saw sriracha on the shelves, I would buy one bottle. That didn’t seem excessive. When I saw sriracha at Wegman’s recently, I bought a bottle. THEN I saw it at Target and bought another bottle. But this week, even my local grocery store had a small supply of sriracha! I did not buy a bottle; hopefully that won’t prove to be a mistake. Anyway. I am really cautiously optimistic about sriracha being BACK because I love it so much.
I may have a wee bit of an addiction.
Wedding Gift Ideas? My hair stylist just got engaged. We have talked about her wedding for almost the entirety of my past two hair appointments. To be clear, I LOVE talking about weddings and wedding planning and enjoyed this line of conversation THOROUGHLY. Am I hoping that she has a baby immediately after she gets married, so we can talk about pregnancy and then babies and then parenting?! YES, with all my heart. She’s always a delight to talk to, but I much prefer this stuff to the usual “what are you doing this weekend, what kind of travel is coming up this year, what are you watching” kind of chitchat, which is pleasant but requires a lot of effort and doesn’t fuel my soul like wedding and baby talk.
I have distracted myself. She is getting married and I want to buy her a wedding present. However. While I have a very well-developed generous impulse, I have a more well-developed gift giving anxiety that makes the whole thing gift giving process more complicated than it should be. I have several months to fret over and prepare for and acquire this gift but it would be really nice if I had A Real Idea instead of considering and discarding ideas for months and never buying anything and throwing some cash at her at the last minute. Maybe cash is the best gift! But a) I get the strong impression that her fiancé is loaded so she wants for nothing and b) she has been my hair stylist for several years now and I like her immensely and I would love to get her something more personal. Do I… ask her if she’s registered somewhere? I kind of think no, considering she and her spouse-to-be are established adults and live in a fully stocked house… but maybe? She likes alcohol, music (although her taste in music is very specific), travel, cats, Christmas, football. Maybe I could get her something she could take on her honeymoon? (Which will be to a tropical island type place.) But what would that be? I will see her again at least once before she gets married, so I could presumably ask her pointed questions to dig up additional information.
HALP.
Persistent Grey. After our bout of snow and cold, we have now returned to abnormally warm temperatures and the persistent grey that weighs so heavily on my soul in the winter time. Yuck. For a few days, the grey seemed intent on inserting itself as forcefully into our lives as possible by way of fog. Fog is eerie and beautiful. But I am so ready to say goodbye to January and get on toward spring. February is my favorite month because it goes so quickly and then it’s practically spring and we can look forward to longer days and blooming flowers and BLUE SKIES.
My poor photography skills don’t adequately capture how much it felt like being in an (the) Emily Bronte novel.
