Authors: E
As my thyroid numbers improved, I thought for sure that I'd be fine. Yes, being “fine” was my main goal. I didn't have cold feet anymore (I was sockless!), and my energy level was much better, but I still couldn't think clearly, nor was I sleeping well. In addition, new symptoms gradually began cropping up, or, should I say, dripping all over the place. I was hot!
I began perspiring in strange places. Let me tell you, I will never forget my first flash. It was not hot outside; in fact, it was a beautiful spring day and I was wearing a lightweight pantsuit. All of a sudden, I felt a flush of heat come over me. When I rose from my chair, I noticed that something wet was dripping down the inner seam of my pants leg! No, I did not pee in my pants. I was perspiring! I am not kidding. Thank goodness I always carry a big purse. (I think big purses make my hips look smaller.) With my purse firmly planted in front of my shmirshky, I ran to my car. I looked down in utter disbelief. What in the world was this? Did I have a perspiring shmirshky? Did my shmirshky sneak off to the gym for a quick 5K while I wasn't looking? I started signing my e-mails “HS (Hot Shmirshky) OMG!” Was I the only “HS” in the world?
It was getting a lot harder to deny that I was in PM. It was sort of like getting stuck in the rain and telling people that it's still sunny outside. You're soaking wetâno one's buying it! My body was dragging me into PM&M, and I did not want to go.
One of the reasons I was able to stay in denial for so long was that I didn't fully understand the sweaty symptoms of PM&M. I thought a PM&M hot flash happened when a shmirshky's face got suddenly flushed. That is true for some, but not for others. While most PM&M shmirshkies get hot flashes in one way or another, we all experience them differently. We are a hot group! Some shmirshkies get them during the day, while others get night sweats. Some shmirshkies get them on their upper body, while others (like me) get them on their lower body. They can range from quick flashes of heat to super sweat sessions like the ones my friends Debbi and Patty endured (see chapter 8, “Sleepless in PM&M”).
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shmirshky party alert!
One of my dearest Gay Husbands,
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Paul, told me a story about a business trip he was on to Switzerland in the dead of winter. One of his brilliant biotech executives was seated next to him when suddenly beads of sweat began dripping down her face. She was glistening in the reading light. Immediately, she began peeling off layers of clothes, one piece after another, until she was down to a sleeveless T-shirt. Later, during a highly sophisticated presentation to a Swiss venture capitalist, the dreaded flash appeared again. This woman did not strip down to her T-shirt during the presentationâthough Paul was sort of afraid that she mightâand not a word was spoken about the flash, as PM&M was definitely not on the meeting's agenda.
What's a business shmirshky to do? Well, many PM&M shmirshkies find it helpful to pack an extra shirt or even a fresh outfit in their purse or briefcase. This might seem silly, but if you're stuck in the Alps in the middle of winter and you're sweating like it's New Orleans in August, you'll be glad you brought along a change of clothes.
On the return flight home, Paul turned to his coworker and said, “You know you're in menopause, right?” They talked about PM&M extensively and he offered his support. (Paul is quite familiar with the topic thanks to his Straight Wifeâthat's me!) Good for Paul for putting PM&M on the agenda.
Sharon told me that she doesn't have hot flashesâshe has night sweats. As any of the sleepless PM&Mers in chapter 8 would predict, Sharon would trade her night sweats for a flash in a flash! Without warning, she wakes up in the middle of the night covered in sweat. The first time it happened, she thought she had experienced a “great sex dream” but just couldn't remember it. She made herself go right back to sleep, hoping she could plug back in to the orgasmic dream. It never happened. The next day Sharon shared her “sex dream” experience with her girlfriend, who was trying not to laugh as she explained to Sharon that this was “no dream, honey,” it was PM&M.
My friend Lisa, age fifty-three, has a sexy new boyfriend. One night, after making passionate love, Lisa curled up in his arms, dozed off, and then suddenly felt hotâas she put it, “I know I'm âhot,' but I also felt like I had a really bad sunburn.” She was “WET, soaking wet,” under her breasts and between her legs. The bed was soaking wet as well. She jumped out of bed, thinking she had urinated in her sleep. Lisa stood there, mortified, wondering how she was going to tell her new boyfriend that she had peed in his bed. It took her a few minutes to realize what had actually transpired, and in the morning she told her boyfriend about the incident. The first thing he said was, “YUK.” Lisa agreed, and they discussed the situation openly. I'm so proud of Lisa and her boyfriend for talking about this and not letting it get in the way of tearing each other's clothes off.
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Everyone's experience is different. Some PM&M shmirshkies find that when they drink alcohol or hot beverages such as coffee and tea, their hot flashes are hotter and their sleep is even more restless! Of course, we all know that when you drink, you seem to eat more. This is not good for the already ever-expanding PM&M shmirshky. Don't freak out too much, though, as not every shmirshky has sensitivities to alcohol. Thank goodness, because cocktail hour helps some shmirshkies open up and talk about PM&M, instead of hiding under that bush.
Ultimately, it was these not-so-hot flashes that forced me out of hiding. I had to admit to myself that I was dealing with more than just a thyroid condition; I was beginning PM&M. That's when my problem solving kicked into high gear.
I needed to read more about PM&M, and fast! So where does the layperson go for help? (What a funny term! The last thing I was thinking of was laying anyone!) Books are a great place to start. Some of them are hundreds of pages long. They can be very technical, very medical, and there aren't any hot romance scenes to keep you awake. Keep reading anyway. This research is critical to understanding what's happening to your body and will help ensure that you can communicate well with your doctor in order to successfully manage your own PM&M journey.
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My first shmirshky recon trip was at a wonderful neighborhood bookstore. I walked all over the store looking for books on PM&M, but I couldn't find a thing! Then I saw the basement. Yes, you guessed itâthe PM&M section was in the basement. I guess PM&M is not cool or chic enough to be on the first floor. I couldn't find any PM&M books on the Employees' Picks table either. Shocker. I dragged myself downstairs and gathered as many books as I could hold (FYI, there are no stairs to deal with when you buy online!). As I stumbled back up to the cashier, I noticed that she was a young shmirshky. She gaped at me as she rang up over a dozen books on PM&M. I told her that I would read them all and let her know how it went. She laughed. I thought, oh man, you just wait.
It didn't take long before I realized that I needed to find a great gynecologist who specialized in PM&M to help me with my sweat-stravaganza. Finding the right PM&M specialist is critical. This might not be the same doctor who delivered your babies or does your routine Pap smear. You may need to dig a little deeper to find a PM&M specialist who's right for you.
This shouldn't be too hard. After all, shmirshkies are gatherers; we know how to find what we're looking for, whether it's a cute new top or the perfect gift for a friend. Unfortunately, many shmirshkies spend more time researching hotels, hairdressers, and restaurants than researching doctors. Have you ever chosen a doctor because he or she is close to your house? I know I have, yet I never simply picked the closest hotel to my destination; I would drive miles out of my way for the most fabulous place to stay. Remember, you've got to think inside the box! Use your finely tuned investigative skills to find a great PM&M specialist. Here are some tips to gathering good doctor recommendations (you can search later for a delicious bite to eat nearby):
⢠If you know a great doctor who excels in his or her specific field, this is an excellent place to start. Great doctors often know other great doctors, and receptionists and office managers can usually get a recommendation for you. If you like your current gynecologist, ask him or her to recommend a PM&M specialist. There might be someone right there in the same office who specializes in PM&M.
⢠Ask trustworthy friends and family for recommendations. I keep an ongoing list of different doctors who people recommend to me. Start keeping your own list, and then you'll be a good resource for your friends as well!
⢠Go online. The Internet is a massive medical resource. You can start by taking a look at the North American Menopause Society's resources for finding a “Certified Menopause Practitioner.” Just follow these links for more information:
http://www.menopause.org/compexam.aspx
http://www.menopause.org/referralservice.aspx
⢠If you happen to know a medical student, or know someone who does, pick his or her brain. Medical students often interact with a lot of doctors and might know of some great doctors in your city or town.
⢠Use local media as a resource. In some cities and towns, a local magazine will dedicate a single issue to rating the top doctors in the area (in the Big Apple,
New York
magazine does this every year and provides a resource on their Web site year round). You can also check Web sites, message boards, and neighborhood e-mail lists for local recommendations.
⢠Ask a lawyer. He or she might know someone who does medical malpractice defense. These people often know good doctors . . . or at least the ones to avoid!
⢠Depending on what type of medical coverage you have, you might need to pick from a list of doctors who are covered by your provider. Be sure to cross-check the above resources with this list.
Now that you've got a list of doctors in hand, it's time to do some research. Here are a few good resources to get you started:
⢠Google the doctor's name and see what you can find. Often a doctor will have a Web site that provides some basic biographical information.
⢠Visit your state medical licensing board Web site and search to verify that the doctor is currently licensed. If you can't find the right Web site, go to the American Medical Association for a link to your state's Medical Licensing Board:
http://www.ama-assn.org/ama/pub/education-careers/becoming-physician/medical-licensure/state-medical-boards.shtml
, or check the American Board of Medical Specialties Web site (this service is free, but registration is required):
https://www.abms.org/WC/login.aspx
.
⢠Check out sites such as
http://www.ratemds.com
and
http://www.healthgrades.com
, where you can order a background check to see if the doctor has any malpractice claims against him or her and is in good standing with the state medical board.
While you're doing this research, think of yourself as a shmirshky private investigator at the center of a sexy espionage thriller. It's always the middle of a hot summer in those stories, so your hot flashes set the mood perfectly. Put on a big-brimmed hat and speak with a 1940s New York accent, and you'll be good to go. You see, looking for a gynecologist who specializes in PM&M can get pretty exciting!
After you gather doctor recommendations and research them thoroughly, make an appointment to meet the doctors and interview them. When you call, be sure to make it clear that this is an interview and not a checkup. I always offer to pay for the interview, but no one has ever charged me for his or her time. If someone does end up charging you, consider it money worth spending. Your well-being is worth the investment.
I know you might be thinking, “Research, recommendations, interviewsâE, this is
way
too much work! I'm having a hard enough time getting dinner on the table, and the kitchen sink hasn't been fixed yet. There's just no time to do all of these tasks.” But honestly, shmirshkies, this isn't as daunting as it sounds, especially considering all the time we spend on slightly less important matters.
Before I make a major change in the color or style of my hair, I usually make an appointment for a consultation. Yet before going through PM&M, I'd never had a consultation with a doctor. How ridiculous was that? My shmirshky is at least as important as my hair! It was time for a new process. It was time to think inside the box and put a high priority on my shmirshky needs. When you interview doctors, don't hold back. Ask
any and all
questions you have. I cannot stress this enough. It's your responsibility to be forthcoming with your doctor so he or she can be in the best position to help you.
It is helpful to take an
advocate
with you to your interview and other important doctor visits (and if you take your advocate out for lunch afterward, the trip can even be fun!). Your advocate can be a loved one, family member, or friend. Often when we do not feel well, we are not functioning at our full capacity and may not hear clearly or speak up. Your advocate can be your extra set of ears and eyes and can help brainstorm with you as you evaluate your choices later.
Before each interview, spend a few weeks using the Shmirshky Daily Symptoms Chart on page 168. It's helpful to fill out your chart at the
same time
each day. I keep mine by my bed, as I find I have more time at night than in the morning when I'm rushing to get to work. Don't worry, it only takes five minutes.
Charting will help you tell the doctor how you
feel
. Think about it: when you are in PM&M you can't remember yesterday, let alone what you felt like last week or last month. Filling out this chart every day will enable a doctor to better understand what you're going through, track your progress, and find a course of action that works for you. Happy Charting!
I learned about the shmirshky interview process through my own mistakes. I found my first doctor through a recommendation, but I didn't interview her. I did interview the next doctor, but I didn't spend any time preparing: I just listened and didn't ask many questions. In retrospect, I could have saved a tremendous amount of time and energy had I brought my symptoms, questions, and advocate along for the ride. I wish I had done my prep work back then, perhaps I would have hit my Shmirshky Jackpot much sooner (more on this in chapter 19, “Shmirshky Jackpot”).
Later on in my journey, I smartened up and took a different approach. I'm going to tell you about that now, so keep in mind, I'm jumping ahead in the story. You erlicks might have a problem with me leapfrogging around like this, but what can I say, I'm a shmirshky and this is how we talk, so here I go!
With my lists of questions and symptoms, and with David in tow, I was off to find a doctor who would help us find me! David and I had two gynecologists to interview: one shmirshky and one erlick. (I would have interviewed a cat and a dog if I thought it would help.) The first interview was with the shmirshky. David and I were taken to an examination room. She seemed to want to interview my shmirshky first, so I figured, okay. I began rattling off my questions as she began perusing my shmirshky. Thank goodness this is not the custom for all interviews or they'd have to install stirrups on the set of
The View
. This doctor answered all my questions and was extremely open about her philosophy, all while examining my shmirshkyâshe was quite an impressive multitasker. She then announced that “everything looked good” and she would be happy to help me. (I wondered, if it didn't look so good down there, would she have told me her practice was full?)
In contrast, at our appointment with the erlick, we were guided into the doctor's private office. I quickly glanced around the room and was relieved to see just two comfy chairs opposite the doctor's desk, no stirrups in sight. This gynecologist was
very
interested in understanding how I felt, what I was going through, and what I had experienced along the way. David chimed in whenever he thought he could shed some light on my dark days. After much conversation, I whipped out my list of questions, but this doctor had already covered almost everything.
Afterward, over lunch, David and I rehashed the interviews, weighing the pros and cons of each doctor. Although tests indicate that I have near perfect hearing, David heard a lot that I missed during these interviews. He was listening intently and was clearly able to recall in detail many differences between these two doctors' philosophies and styles.
My
concentration, on the other hand, was impaired by my lack of sleep, by my highly emotional state, and by my nagging desire to rip off my annoying tight pants!
At each of your interviews, get a feel for how the doctor's office is run. Be sure to get answers to the following questions: How do you reach your doctor when you need to talk
during
office hours? Then ask what the doctor's
after
-hours protocol is. For example, who is on call: the doctor, another doctor, a nurse practitioner, or an answering machine? Remember the game called telephone we all played at sleepovers? You know, when everyone gets in a circle and the first person whispers something to the next gal, and then she is supposed to repeat exactly what she heard to the next gal, and so on and so on until the last person stands up and repeats what she heard? The original message is a scrambled mess by the time it gets to the end. Don't play the telephone game with your doctor's office. It could result in a misdiagnosis.
Next, get a feel for the doctor's approach to his or her specialty. What is the doctor's philosophy? Ask how he or she approaches preventative medicine and the treatment of symptoms. What tests and procedures does the doctor typically run? If there are controversial topics relating to the doctor's field, ask what his or her philosophy is about these subjects. When you're seeing a doctor for PM&M, ask about his or her philosophy on HRT
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and other PM&M treatments (more on that fun stuff later in chapter 15, “To HRT or Not to HRT?”). You will get a good feel for the doctor's personality and approach to medicine by discussing these topics.
Also, ask the doctor how he or she feels about patients getting second opinions before making major medical decisions. A doctor is at his or her best and brightest when prioritizing the patient's well-being over personal ego. If your doctor has a problem with second opinions, think about switching to one who is not only comfortable with the practice but actually welcomes it.
Many shmirshkies avoid finding a good PM&M doctor as a last line of defense in the shmirshky “I'm fine” cover-up. After all, deciding to get help means accepting that you need help in the first place. Remember that we can't be “fine” all the time. If you're feeling overwhelmed, try allocating a specific time for each task. A phone call only takes a couple minutes. And in the end, taking these few extra research steps will actually be a
shortcut
; the sooner you find the right PM&M specialist, the sooner you will feel better.
Break the cover-up cycle and be
honest
with your doctor. This sounds easy, but it's a bit challenging at first to be okay with not being “fine.” Think of the doctor-patient relationship like you would a business partnership. Would you go into business with someone who doesn't listen to you and sincerely respect your opinion? You and your doctor are partners too. Both of you need to be able to communicate openly and freely. Your journey will be much easier if you have the right doctor on your team. Don't settle for less than you deserve!