Authors: E
Pushing all these fears aside left me anxious, lonely, and desperate to feel better. Still I kept on pushing. After all, I pushed out two babies; I could certainly push away these bothersome thoughts. I was a happy person, and I was not interested in being sick or “less than.” I didn't talk about this with
anyone
because talking about it would make it real. Instead, the voice in my head kept secretly chanting the old-school shmirshky mantra: “I am fine. I am fine. I am fine.”
When a shmirshky says she is “fine,” this is the first sign of “the cover-up.” Yes, we shmirshkies are really good at the cover-up. It's not that we don't want to be honest with those we love, but rather that we aren't honest with ourselves. We're afraid of being less than: less than perfect, less than 100 percent functioning, less than able to juggle it all. I think you get itâ“less than” typically doesn't sit well with a shmirshky.
All this cover-up has helped make PM&M a huge secret. I understand that it's way more fun to talk about a new movie, fashion, sex, politics, or food, but we need each other for this one. We need the Sisterhood to help us through. We need our mothers, special aunts, and revered elders to share. When I asked my mother how PM&M was for her, she told me that she didn't have time for it. That was thatâend of discussion! I'm reminded that this was the same person who told me never to let a boy touch my thigh until I was married. Word spread pretty fast that I wasn't exactly the hottest date in town.
For some, it can be embarrassing to admit PM&M is challenging and, at times, very depressing. I am here to tell you loud and clear that it
can
be quite difficult. Each shmirshky will have her own journey. Each of our bodies is different, as different as every shmirshky's breastsâno two are alike. This is the challenging part. It's not black and white; it's all gray. I recently read in a fashion magazine that gray is the new black. This brought me no comfortâI yearned for black-and-white answers.
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shmirshky party alert!
When I asked Patty if her mom had ever prepared her for PM&M, she responded, “Absolutely not!” Patty told me that her mother never spoke about it and to this day maintains that she never went through menopause. (Trust me, she did go through it!) From Patty's perspective at the time, her mother “simply had a breakdown. She got into her bed one day and stayed there for four years.” Patty, a teenager then, stepped in and “kept stuff together,” making the holiday dinners as well as the daily lunches for her sister. She used to color her mom's hair once in a while in the hopes that covering the gray would somehow help her mother feel better. Unfortunately, hair dye does not fix PM&M. It must have been so difficult for Patty to be the child
and
the mother at such a young age.
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I remember my mom telling me that she had to take a leave of absence from her teaching job to come home and take care of my grandmother when my grandma was around fifty. Apparently my grandma had become very depressed. I never realized what that was all about until recently. Perhaps my grandmother was going through a PM&M depression. Back then, doctors gave people shock treatments for depression, and I wonder if that's what happened to my grandmother. She was a vivacious shmirshky who loved to celebrate lifeâfar from depressed. But even the most spirited shmirshkies can drift into a depressed state during PM&M. I wanted to reach back in time to hug my grandmother and tell her I understood exactly how she felt.
After hearing that, I totally realized why my mom didn't have time for PM&M. Do you blame her after what her mother went through? This is another reason why PM&M became such a secret. Why would women want to talk about what was happening to them if it meant possibly receiving shock treatments as a result? It's no wonder that my mom's favorite saying is “I'm fine, fine, super fine.”
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shmirshky party alert!
My marvelous graphic designer friend Sharon had a grandmother and grandaunts who were institutionalized for a time in their late forties and early fifties. Sharon suspects that this was PM&M-related, although she told me that during her own hardest PM&M moments, the thought of getting locked away in an institution where they “take care of this new you and put you back together” didn't sound so bad! Unfortunately, the older generations of shmirshkies weren't exactly going to Club Med.
My extraordinary book maven friend Blanca had a slightly different experience with her mom. She told me, “When my mother was going through it, she let me know it was happening, but I was just too preoccupied with my own life to give a hoot.”
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It can be jarring when we see our mothers and loved ones suffering. This can lead to a PM&M cover-up in reverse. Sometimes we understand what they are going through and sometimes it's a mystery, but either way, it's our responsibility to acknowledge and educate ourselves about their struggle. This can be easier said than done.
Whole generations of shmirshkies have been involved in the cover-up, and everyone tends to think they have to be “fine.” I'm sad that my mother and grandmother handled it all alone. I don't want any more shmirshkies to feel alone. Let's not repeat the years of silently suffering through PM&M. Let's bust open the shmirshky cover-up and sound the alarm for others to think inside the box.
By the way, next time a shmirshky you love says she's “fine,” ask her how she
really
feels.
You can't!
PM&M arrives unscheduled, uninvited, and often sooner than you'd think. The biggest myth about PM&M is that it begins when you're
old
. This is simply NOT TRUE! PM typically begins in your forties, when you're young and active.
PM&M arrives like a baby's first tooth. It breaks through at a different age for each person. Some shmirshkies begin the PM&M process when they're thirty-eight, some when they're forty-eight. There is no right or wrong age for PM&M, and you won't receive a “save the date” to let you know when the festivities will begin.
There's no rhyme or reason to the length of the process either. The perimenopause stage can last six to ten years before you finally hit menopause. Contrary to what many people think, you don't technically hit menopause until you've been period-free for twelve consecutive months. Between the onset of your first symptom and the point at which you hit menopause, there's enough time for bell-bottoms to be in style, go out of style, and then come back in style again.
Regardless of when you begin the perimenopause stage, if you hit menopause when you're
under the age of forty
, it's generally classified as premature menopause. I know, the word
premature
makes it sound like you started the race before the gun went off. Don't worry; if you are experiencing premature menopause, you won't be thrown into some sort of menopausal doghouse. Premature menopause may occur as a result of one's genetic makeup, an illness, or medical procedures such as a hysterectomy.
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Since there's no magic age for the onset of PM&M, there's no need to feel ashamed or embarrassed about the nature of your symptoms or the timing of their arrival.
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This chapter is not about waxing, laser hair removal, or shaving your shmirshky; it's about preparation. So many shmirshkies pride themselves on being prepared. If you look in our purses, you may find anything from a complete outfit change to a spare tire. Mothers of young children routinely walk around with a whole nursery in their diaper bags and enough hand sanitizer to sterilize an entire country. My mother is ninety years old and still keeps a piece of paper in her purse that lists the day I got my period and all the vaccinations I've had since 1953, just in case. This is the kind of preparation I'm talking about.
The Sisterhood is so prepared and open when it comes to childbearing and child rearing. From pregnancy to college applications, my friends and family were always full of support. One of my favorite pieces of advice was from my friend Melody, who helped prepare me for when my daughter, Sarah, became a teenager. Melody told me that when Sarah hit puberty, she would wake up one day and hate me. I recall looking at my precious little blonde, curly-haired baby girl, age four, dressed in her favorite sparkly pink ballerina outfit with spaghetti stains on it, and somehow, I couldn't imagine that she would ever hate me! How could our relationship ever get to that point? We had so much fun together.
In anticipation of this, I began telling Sarah (when she was a preteen) that someday soon she would more than likely find that she hated me. She was as shocked as I was. I proceeded to explain that it would only be temporary and that she should not feel guilty about these feelings. They were normal for teenage girls. I assured her that I would understand and that she would grow out of it.
When Sarah finally hit her teenage years, I repeatedly asked her, “Do you hate me today?” We'd both laugh. As in any close relationship, tensions did inevitably arise, but thanks to Melody, we were prepared. I can't thank her enough for this wonderful advice.
Of course, you can't avoid PM&M (or mother-daughter animosity) just by being prepared. However, if you're busy hiding from your shmirshky and the challenges of PM&M, then you will not be equipped to handle what may lie ahead. Here are a few things to keep in your PM&M Prep Kit: sticky notes; tweezers; a hand fan; a lot of patience, love, and support; and a tampon (trust me). Remember the Girl Scout motto: “Be prepared.”
For the first half of my life I was a great sleeper. If they gave out gold medals for sleeping, I would have been adorned with them. On a plane, a subway, a bus, a car, or during a boring speech, if I was tired I would nod off into a wonderful sleep. Often on the car ride home from dinner parties, my friends would take bets on how long it would be before my chin began its descent into my chest. Thank goodness drooling was not part of this act.
Suddenly, my gold medals flew off and I became sleepless. Yearning to be “fine,” I dismissed these sleepless nights as fluke occurrences. Maybe I was stressed, maybe I had eaten too much, drunk too much, or not exercised enough.
Still, night after night I found myself unable to sleep. Often I would fall asleep, then wake up around 3:00
A.M.,
unable to fall back to sleep. Other nights I would toss and turn, dozing for an hour or two at a time. I was so tired, but I couldn't sleep. It was torturous.
I love the movie
Sleepless in Seattle
, but sleepless in PM&M is neither cute nor romantic. My nights became one big nightmare: lonely, depressing, and exhausting. Instead of jumping out of bed in the morning with a smile, I found myself struggling to function. Along with my sleepless nights came incredible mood swings, random tears, and an MIA sex life. (See the Shmirshky Daily Symptoms Chart on page 168.) David and I were both worried about me and our relationship. Was this going to be our life together from now on?
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shmirshky party alert!
My friend Debbi's Olympic-quality sleeping habits came to a halt one night when she suddenly felt hot, boiling hot! Debbi's experience was like getting stuck outside during a record heat wave surrounded by hundreds of people with no room to move. Her heat rush was routinely followed by a downpour of sweat resulting in a soaking-wet nightgown, drenched sheets, a chill, and plenty of anxiety. These sweat sessions kept her and her husband up at night, with a pile of laundry rising alongside their bed and no sleep in sight. Oh joy!
Patty had a similar experience. She would lie awake at night, soaking wet, staring at the ceiling. She was so hot, she felt like she had to inch away from her husband. Maybe Patty should have worn a sign that read
DANGER: DO NOT TOUCH THE SLEEPLESS SHMIRSHKY
.
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A 2008 study done by researchers at the University of Arizona College of Nursing found that the #1 biggest problem for shmirshkies entering M (94.5 percent of the shmirshkies in this study!) was sleep deprivation. So, although I
felt
totally alone, clearly I was far from the only shmirshky experiencing this symptom. Next time you can't sleep, instead of counting sheep, try counting sleep-deprived PM&M shmirshkies.
It's true that PM&M can be pretty complicated. To make it even more confusing,
some
shmirshkies find that when the PM&M storm starts to brew, it goes from rain to sleet with the onset of a thyroid condition.
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It can be difficult to differentiate a thyroid condition from PM&M because some of the symptoms are very similar: nervousness, irritability, fatigue, depression, difficulty sleeping, night sweats, and changes in menstrual patterns, to name a few. Often, shmirshkies brush off thyroid imbalance symptoms as part of their PM&M experience. Don't make this mistake! You can have serious health issues if you leave a thyroid condition untreated.
Don't stop reading, baby! There's more thyroid info on the next page, but I'm keeping all the footnotes on their proper pages so you don't have to flip back and forth. Odds are, you're already flipping out as it is!
Thyroid conditions come in two common forms: hyperthyroidism
12
and hypothyroidism.
13
Are you a hyper/hypo? Be sure to get your TSH
14
levels checked to find out (see chapter 14, “Shmirshky Numbers”). Also check to see if anyone in your family has a thyroid condition, as it can be hereditary. I know what you're thinkingâPM&M is quite the handful all by itself, give me a break already with this thyroid business! Believe me, you're preaching to the choir. Bear with me for just a bit while I walk you through the experiences of my friend and me so you can see how important it is to proactively manage your own health.
At my yearly physical exam, my doctor announced that I had Hashimoto's disease.
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I thought, “What in the world is that?” The name sounded like a breakfast cereal, a rare butterfly, or something I would yell before I tried to chop a block in half with my bare hands. The word
disease
really bothered me too. I couldn't imagine that I had a disease. No way, no how!
This
new
doctor pointed out that over the past five years, my blood test results had shown that my TSH was way too high. I was shocked. He gave me the name of an endocrinologist
16
to go see about my thyroid. I didn't research the doctor or question this referral in any way before making an appointment with him (big mistake), but I
did
rush home from my physical so that I could Google Hashimoto's disease and thyroid conditions.
The hypo symptoms were me to a T, especially the increased sensitivity to cold. Wow! For years, I had complained to my previous doctor that my hands and feet were constantly cold. He continually told me not to worry, that I just had poor circulation. I cannot believe that I walked out of his office every year comfortable with that answer, comfortable living with freezing feet. Since when was bigmouth me such a wallflower? Remember, shmirshkies are great at the cover-up. To problem-solve, I covered up my freezing dogs with the heaviest, warmest thermal socks I could find. I even wore those beauties to bed every night. Did I mention I lived in Arizona at the time? I know what you're thinking: who wears thermal socks to bed when it's 110° outside? All I can say is thank goodness David didn't have a foot fetish!
In my research, I learned that it is recommended for anyone with a thyroid imbalance to have a yearly ultrasound scan
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of the thyroid gland in order to detect nodules that may have gone unnoticed by a physical exam. These nodules can be cancerous. This was an important test, and I wanted to be sure not to forget to ask for it.
I arrived at the specialist's office with my ultrasound sticky note in hand. He did a physical exam of my thyroid gland and said he was going to put me on medicine that would bring my TSH back down to normal. I told him that I wanted to have an ultrasound of my thyroid as well, but he insisted I didn't need one because he didn't feel any nodules. I guess he thought he had magic hands, but that wasn't going to cut it for me. I stressed that I was very proactive about my health and wanted the scan as a precaution, thank you. My gut told me to get this test. This was (and still is)
my
body and
I
get to decide! He was very annoyed with me, but I wasn't leaving his office without an order slip for the scan.
Guess what the test results revealed? I had a nodule on my left thyroid lobe. It took great restraint for me not to tell him where he could shove those
magic hands
.
If you're intimidated by your doctor, find yourself unusually afraid to speak up, or feel you're not being heard and respected, then consider finding another doctor. Remember to listen to your gut and
do not
settle. Do not be afraid to change your doctor. It's not like getting a divorce; a lawyer is not required.
Needless to say, I found a new endocrinologist, one who is very well respected in the medical world, conservative, and a good listener. After a biopsy and eventually surgery, we discovered that the nodule was benign.
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Still, I have to stay on my meds to keep my thyroid balanced.
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shmirshky party alert!
Maria's mother and two sisters all have hyperthyroidism
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(remember, your susceptibility can be hereditary), and when she told me about her sister's traumatic experience, my heart just sank. “My forty-five-year-old sister was in such denial about her symptoms that she waited to get help until she was unable to carry her groceries up to her apartment without resting in between steps. Unfortunately, she waited so long thatâalong with other permanent long-term side effects like hair loss and bulging eyesâshe suffered heart damage and needed a valve replacement.” The consequences of the “I'm fine” mentality can be severe and sometimes irreversible.
Even after her sister's traumatic experience, Maria didn't associate her own symptoms with what her sister had gone through. At forty-four, Maria started experiencing a huge metabolism shift. She lost thirty pounds in six weeksâcan you believe that? She suffered from extreme fatigue, a racing heart, and tremendous night sweats. Maria was accustomed to swimming one hundred laps a day, and suddenly she was struggling to catch her breath after just one. She thought she might be experiencing PM&M symptoms and was determined to be “fine,” but as the days progressed she became increasingly edgy, paranoid, and angry. She just couldn't live like that anymore.
After eight weeks of suffering, Maria finally broke through the cover-up and called a doctor. (Hallelujah!) With the help of a wonderful endocrinologist, she was diagnosed with hyperthyroidism, received radioactive iodine treatment (RAI), and is now on thyroid medication, which requires periodic monitoring. Thankfully, Maria was properly diagnosed before any permanent consequences set in.
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Dramatic hyper/hypo stories are common among PM&M shmirshkies. If it doesn't affect you, odds are it is affecting a shmirshky you know and love. Ultimately, we all have to take responsibility for our own well-being. Learn your family history and get yourself in to see a doctor if you are experiencing persistent symptoms.