perimenopause

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Five for Friday

I am so scattered lately. So. Scattered. Is it the time change? Is it perimenopause? Am I experiencing the early signs of dementia? WHO KNOWS.

*sob*

Keeping Track of Things You Need to Do: This feels like the dumbest question ever (and yet I feel like I have asked the same or a very similar question before, which… well, it says a lot), but I am 100% serious: How do you keep track of things you need to do?

Back in the middle ages of 2005 or so, I kept a physical planner. At least, I’m pretty sure I did; I remember buying extra pages to insert into the planner. I am assuming that’s how I kept on top of tasks and meetings etc. When I worked in an office, everyone used Outlook to keep track of those things. I have a dim recollection of getting a little pop-up notification on my screen five minutes before my next meeting. For years now, I’ve been keeping all my appointments and things in my phone’s calendar. But more and more often, I find that I’m straight up MISSING things. I failed to show up for a doctor’s appointment last fall, which is super embarrassing, in large part because my husband finds it SO frustrating when people fail to show up for appointments with him. I have been *sure* that I already had appointments on my calendar, only to find that I had never scheduled them. The other day, I was supposed to attend an informational meeting and, even though I rescheduled plans because of it, and even though my entire family was aware I needed to attend this meeting, I forgot about it completely. If I make any tiny deviation in my normal morning routine, I will forget critical necessities for myself and family members. Let me tell you, I feel like I am losing my mind.

One thing that has helped, slightly, is for me to program multiple “alerts” into each calendar entry. So if I have a hair appointment, I put in an alert for a week prior to the appointment, then for a day prior to the appointment, and finally, for an hour prior to the appointment. This seems to do the trick. But, and this is CRUCIAL, it only works if I remember to program the alerts, which I apparently did not do for the recent informational meeting.

I don’t know why the second alert comes before the alert; it works out the way it should.

I am pretty sure I complained in recent months on this very blog about forgetting to take my regular daily medications, and I resolved that by a) taking everything at one time instead of some in the morning and some at night, and b) programming a recurring alarm into my phone, with the title “Take medication.” I suppose I could do that with lots of things, but also I am wary of having too many alarms. That seems like it will become quickly and counterproductively overwhelming.

I have spent way too much time thinking, plaintively, “But I used to be able to just remember things!” For whatever horrifying or normal reason, I can no longer count on “just remembering things.” What I *do* need to do is find a system, because I am tired of and irritated about feeling like a flaky dumbass so often.

Good Chips: It’s no secret around here that I love me some tortilla chips. My kid loves plain old Tostitos, but they have become prohibitively expensive over the past six to twelve months. I only ever buy tortilla chips if they are on sale or if I happen to be at Trader Joe’s when I am in need of tortilla chips. This restriction is how I discovered these chips; they were on sale at my local grocery store. And they are SO GOOD. Flaky and crunchy and light. Good flavor, good salt level. They taste pretty darn close to the handmade tortilla chips you get at a Mexican restaurant.

Workout Workaround: A few months ago, I strained my forearm. It has been painful ever since, and hurts even when I use that hand to lift something light, like a carton of yogurt. This means that I haven’t been able to lift weights, even though strength training is my preferred method of exercise. I tried resting the arm, I tried stretching it, I tried whining about it anyone who would listen. Nothing worked. But then I found this video with some specific massages and exercises for forearm pain. I wouldn’t say it’s fully resolved the pain, but it has helped SO MUCH. I have also decided that I can’t just never lift weights again. But instead of doing a few reps of heavy weights, I decided to seek out some workout videos featuring high reps of small weights. This one is my favorite so far. Some of the exercises strain my arm even with my lightest weight (5 pounds / 2.27 kg), so when I encounter one of those, I use no weight at all. I have been pleased with how sweaty I get during these workouts and by how shaky my arms and legs and abs get by the end of the video.

Summer Stripes: We have reached the portion of the year where I am longing for an all new wardrobe of spring and summer clothing. Not that the weather is cooperating; I went for a walk with a friend yesterday and had to wear gloves and my winter coat, and for the first half of our time together I was kicking myself for not bringing a hat and scarf as well. But the heart wants what it wants.

Currently, my heart is fixated on summer weight pants with a vertical stripe. I have tried buying several pairs of pants of this nature, but nothing – so far – has stuck. First of all, these pants sold out after I’d ordered them, but before I received them. Boo. They seem perfect. I am on the fence about these jeans. On the one hand, they are cute enough. On the other hand, they are jeans and I really wanted something light and breezy. On the other other hand, they are light and I feel like light colors emphasize the wrong parts of my body. These pants are cute in theory but look terrible on my actual body. These pants are pretty cute, and I like the material, which is silky. But they are black and I really want blue pants. Maybe I will order these.

The main problem with these pants of my heart, aside from them not looking great on me, is that I am now struggling to differentiate them from pajamas. I don’t really want to look as though I’m gallivanting about the world in pajamas.

Obligatory Cat Photo: My cat is weird and adorable.

He likes to hang out like this. Perfectly normal way to use the stairs.
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Routine Doctors Appointments

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 pleased I 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: 

  1. 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? 
  2. 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.
  3. 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.

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Six on a Saturday

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.

What’s on your mind this weekend?