Tuesday, May 8, 2012

Menopause and Meeting with an Expert

Nine months ago I made an appointment while on vacation to see a female doctor who is also an expert on all things menopause. She works at a top Massachusetts hospital that I hold in high regard. I knew it was a long time to wait, but also knew by the time I went to see her I would have had a chance to put into practice a plethora of steps needed to get my perimenopause journey moving into a better place. Which it truly has, and you can read all my previous posts to see what has been working so far, although I have a few more to write on exercise, nutrition, acupuncture, and socialization. All this and more. It is a never ending journey as far as I am concerned.

But I wanted to jump ahead to talk about this appointment and what learned from it in the hopes that it might offer those of you some help.

I showed up for my appointment on time but found that I had to wait close to an hour and half until the doctor actually saw me. She brought me into small, but bright and cheerful office where lots of light filtered in through the floor to ceiling windows. We sat at a tiny, circular faux wooden conference table. She told me she had read my answers that I had graciously provided on a lengthy, but not overly long questionnaire. Her manner was practiced and kind in that way this particular hospital has of training its medical staff. I think you know what I mean, the doctors use just the right amount of eye contact, compliment the patient, smile, compliment the patient, seem approachable while maintaining expertise, compliment the patient. It is a well practiced dance routine common to the doctors at this hospital and probably at most major hospitals across this country. I am not entirely comfortable with this brand of patient/doctor relationship, it does seem a tad forced and off putting. I would prefer the comments and gestures be more spontaneous, but I totally get the fact that after seeing hundreds of clients, one can get a bit over rehearsed in their manner and it can come across rather fake.

If you are wondering why I am not revealing the name of this doctor it is two fold. First, once she heard that I was the author of a blog for women about menopause she graciously told me to print any of the handouts she gave me so that others may share in the knowledge. (I do want to mention here that all the handouts she gave me were provided to her by http://www.menopause.org/Consumers.aspx NAMS: The North American Menopause Society. She also told me that she is no longer accepting new patients as her practice is full. I can understand why as I think there are truly few doctors in this country who specialize in menopause and I am sure the wait list for them is exhaustively long. She asked that her name not be mentioned and out of respect to her full practice, I am agreeing not to reveal it here, in print.

I also want to say that while I did find much of what she said to be "old hat" to me by now, I did get the information I specifically came for which was to find out her perspective on breast cancer survivors and HRT (hormone replacement therapy.) She was not in favor, which came as no surprise to me, and even brought up, in a somewhat disparaging tone, that Suzanne Somers is misleading a lot of women and she hoped I was not buying into her thought process. Funny that she mention that name, because at that moment Suzanne Somers and her own experience with HRT or bioidenticals as she calls them were the furthest thing from my mind. But I realized she must hear it from her patients a lot and needed to get it out on the table to me before we preceded. I thought this was all rather humorous!

So, I listened and learned that it may not be such a bad thing for me to try Black Cohosh, an herb that does indeed help women with hot flashes. Although she did say my breast surgeon may not agree. And  since many of my symptoms have abated or been significantly improved this was one of the last ones that had been improved somewhat, but still prevalent. So I started Remifemin three weeks ago had have noticed a reduction in the number of nights I am awakened by heart palpitations and hot flashes. So I am pleased with the results so far.

A word of caution not all doctors like to see breast cancer survivors on this herb, so use your discretion. My breast cancer was DCIS, non invasive, microscopic and did not require chemo or radiation. So I feel as well as this doctor, that given this fact, that it is worth the slight increased risk to help me sleep better and be a better mom, wife and person in general. Every one comes to this from a different perspective, do what works for you!

Plus,  I DO NOT like the alternatives: conventional HRT is not something I want to utilize. Nor do I want to take off label drugs such as antidepressants or anti- seizure meds to help with hot flashes. I think the side effects and weaning off of both these types of drugs is not in my best interest. My depressed mood at times come more from lack of sleep, or from the drop in estrogen, not clinical depression. And I do not suffer from severe hot flashes, which is the reason why some doctors are prescribing gapapentin, an anti-seizure medication, to help women sleep at night.

There is a terrific book I mentioned previously: Mind Over Menopause by Leslee Kagan, MS, NP at Harvard Medical School. She goes into detail on all I mentioned here and more and is a great proponent of not using medication and HRT to ease one through menopause.

Plus,  I cannot overemphasize enough how a daily mindfulness/meditation practice, yoga and exercise program truly help to to reduce the frequency of hot flashes. There are numerous studies available on all this and more. Simple fact: it works!

So in conclusion: my visit to the expert was helpful to me in that it gave me another thing to add to my personal regime to help me cope. She was very generous with her information, and as I said you can find it all and more at the NAMS website on the link above.

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