"Treat the disease, you win some, you lose some. Treat the patient, you always win."
~Patch Adams~

Saturday, September 22, 2012

Sometimes we all need a reminder-------

Tuesday, September 18, 2012

Here's a weight loss tip for you: Get some sleep!

I've written posts on this before, but not in a while......getting adequate sleep is crucial in losing weight and maintaining that weight loss. Trust me on this one, I know what I'm talking about. Check out this article from Todayhealth.Today.com.

Weight and sleep issues are two of the most common complaints I hear from peri/menopausal women, and I have been there (and still am) on both counts. I know that when my sleep improved with the hormonal balance, the weight was easier to lose, and easier to keep off. Conversely, I know when I go through periods of either elevated pain or high stress, my sleep gets way off, and I CRAVE sugary, sweet junk food.....and the weight goes up with literally no effort. I'm far better about controlling my cravings, but it will always be a struggle. My cortisol (stress hormone) level is always elevated, but once my hormones got balanced (and I felt so much better), my sleep improved, and my cortisol level has dropped by about 30%. I also take Cortisol Manager (by Ortho Molecular) at night, and I know that has helped my cortisiol level. When my cortisol is lower, my sleep is better, so it's a cycle.

Sweet dreams!

Sunday, September 16, 2012

We have far to go in educating people about biodientical hormones:

(and yes, I get that I am somewhat on a rant today...funny how these issues come up in batches!)

Many of you know, either from remarks I have made on this board, or from reading my Needle Notes blog, that I am a knitter. I never have less than three projects on my needles at any one time (right now it's a scarf, another scarf, a man's sweater, and I am using my very limited crochet skills on a baby blanket for a friend's grandchild) and I have used knitting not only as a way to pass time and be involved in a hobby, it is often very good meditative therapy for me. I have knit to manage pain (if I am absorbed in my knitting I can relax a little more and my back pain seems not so overwhelming), to manage stress, and I have met some great people through knitting groups.

I'm a member of an online knitting group called Ravelry, it's a social media site for knitters, crocheters, and fiber artists of all kinds. Some people refer to it as Facebook for Knitters, but it's not set up like Facebook, there are all sort of groups you can join (or not join) and it's a great source for education, patterns, connecting with others of similar interests, etc. There are groups for nearly any interest you can think of, political, demographic, fiber interests, religion, non religion, and so on.

I'm not going to name the board that this was on, but I was alerted to the post and asked to respond. This is what the post said (there has been an ongoing discussion of the problems with menopause, hot flashes, getting older, etc. and I have detailed my experiences with bioidenticals numerous times--in fact, my Ravelry name is Holyhormones....not surprising, I am sure):

My husband is an endocrinologist. He says that bio identical hormones have exactly the same effects, pro and con, as any other sort. In other words, your body responds to estrogen in the same way whatever its source. There are lots of bio identical adherents, but there are no good evidence based studies that support it. HRT is HRT and the risks are as great. I wouldn’t take the risk (but then, full disclosure, I didn’t have hot flashes), but it certainly wouldn’t hurt to get a second opinion from an endocrinologist, or from a GYN who specializes in menopausal problems (as opposed to someone who mostly does OB)
Recent true story: Last month I saw my very sweet, female dermatologist to get a renewal on all my prescriptions, and a skin check. One of my Rx has to be compounded by the pharmacy, which Walgreens will do. She mentioned that if I had trouble getting it she could refer me to a compounding pharmacy and I replied that I had used one near my home. She suddenly looked very alarmed and asked why I was going to a compounding pharmacy, and was relieved that the answer was to get an antibiotic for my cat, who needed a human drug in a chicken broth suspension. Her response was that she was relieved, and had been concerned that I was using bioidentical HRT which could have been the cause of my thinning hair. Yet another reason to be wary!

Those of us who have researched and experienced bioidentical hormone optimization know that this statement is simply not true. Premarin and Prempro are not hormones, they are drugs, and as such, have significant risks and side affects associated with their use. These are the drugs that were used in the infamous 2002 WHI study that is often cited by healthcare professionals who argue that ALL hormones are dangerous. Why Premarin and Prempro are still being used is beyond me, but that's a discussion for another day. I found it also interesting that the endocrinologist only addressed the issue of estrogen, when in fact hormone balance is not just estrogen, but also progesterone and testosterone. If your doctor is just slapping an estrogen patch on you to get you out of his office (the estrogen/estradiol in the patches is bioidentical), think about getting another doctor who is an expert in hormonal balance.

Bioidentical hormone optimization is simply replacing what was in our bodies that we lose as we age, and we are replacing it with hormones that (while synthesized in a lab) are molecularly identical to what is in our bodies. Huge difference! In very simplistic terms, we (especially women, but men also) develop a myriad of health issues as our hormone levels decline....mood swings, hot flashes, depression, sleep disruption, loss of libido, (and I am one of those people who thinks sexual health is vitally important) thinning bones, elevated cholesterol, increase of abdominal fat, heart problems and I could go on. Doesn't it make more sense to simply replace what was lost in our bodies than to prescribe a myriad of expensive, toxic drugs to simply mask symptoms or manage the illnesses brought on/exacerbated by hormonal imbalances? As my doctor is fond of saying when he hears me raving about another person I know who has been put on antidepressants for hot flashes "She doesn't have a Prozac deficiency, she has a hormone deficiency!" I could also do a lengthy post about how many side effects there are in the drugs used for many illnesses/conditions that could be helped by hormone optimization, and I likely will at some point, but that too is for another day.

I know what I'm talking about because I have been on both sides of the drug/hormone issue. When I moved to North Carolina (and before I met Dr. Carr and my pain managment physician Dr. Hines) I was on so many drugs I filled up a large Ziploc bag. Two kinds of blood pressure meds, antidepressants, Concerta for ADD, Provigil to wake me up, anti anxiety meds, anti-inflamatory meds and on and on.......and at 320 pounds, it was pure luck I hadn't developed diabetes or a heart condition (yet). I also had osteopenia, the precursor for osteoporosis, even more dangerous for me because I was prone to falling (and looking back, I think some of it was from being unbalanced on all those medications). How I managed to get out of bed and function on all the meds I was on is absolutely beyond me (and my doctor). I was in a fog most of the time, had zero energy, and oh, yes, my pharmacy bill between me and my insurance company was over $700 per month.

Once I got on the hormone optimization protocol, I was able to eliminate 6 medications within 6 months. Now all I take by prescription (besides my bioidentical hormone creams) is thyroid hormone (my previous physician kept telling me my thyroid was normal, but now I know there is a big difference between normal and optimal), and medication for my back. Everything else is supplements, I take about 8 different supplements daily, including Vitamin D3 (5000 ius). My energy level is far better than it ever was, my osteopenia is completely resolved, my lab values come back right on the money, my cognitive functioning is way improved, and my quality of life is far better than life before BHRT. Oh, and an interesting point, I used to have very cystic breasts, which is thought to be a risk factor for breast cancer. My breasts were so lumpy that getting a breast exam with any new practitioner took forever because they were concerned they had found a problem. Within three months of starting the progesterone, my breasts had almost completely smoothed out, the difference in doing self exams now is remarkable.

Another interesting point regarding the thinning hair: my hair since being on the bioidentical hormones (especially the progesterone, that's the one I started with and the others were introduced gradually) is (without modesty) GORGEOUS! I wear my hair short, but it is thick, healthy, shiny and hold my style beautifully. Even Dr. Carr has commented that most women my age would kill to have the bounce in my hair that I do, which of course makes my stylist very, very happy. My nails have never been stronger or healthier (and I am tough on my hands)----I rarely break a nail, and they do not split or bend the way they used to.

I plan to respond to the comment posted in a thoughtful, reasonable post (as soon as I stop grinding my teeth). I know that I am doing what is healthy for me, and I am blessed to have a doctor who cares enough about his patients to think for himself and want the best for his patients (and in case you are wondering, Dr. Carr takes bioidentical hormones himself and has for years).

A cautionary tale-----

Hope everyone has had a great week and is enjoying the second half of the weekend. Very cloudy and gloomy here in NC, it would be a good day to settle in and read or knit. I have far too much to catch up on, however, for that luxury today (including catching up on the blog) so at the end of the day, I am hoping to feel very accomplished!

I sometimes think I am jinxed with compounding pharmacies. I have detailed the multiple issues I have had with both Town Center Pharmacy and Fireside Pharmacy in Palm Desert, CA. Messed up orders, having to ship hormones back to them to get replacements (at my expense) when they are the ones who messed up, and so on. My last prescription of progesterone cream from Town Center Pharmacy was awful, whatever base they used "shredded" all over my arms, and I more than once had to change outfits because the progesterone shards got all over what I was wearing. This time I didn't even bother to contact them; not worth the effort, they have blown me off on more than one occasion and it's not worth getting upset about anymore.

Got my latest batch of progesterone at Greenfield Pharmacy in Vista, CA (Dr. Carr uses them for hormone pellets and has been very satisfied with their quality). I called them on Tuesday, 9/4, inquired about the price for my progesterone, and placed the order (they had to call and get it transferred from Town Center Pharmacy). They promised to call me back as soon as the order was filled and get my credit card number (word of advice, don't leave your credit card number on file with a pharmacy, I learned the hard way after several screw ups!). I hadn't heard from them by Friday, 9/7, so I called and asked if the hormone was ready. The person I spoke with told me "well, it often takes a couple days to compound". If that's true, a couple days would have meant it was ready on Thursday. She put me on hold and when she came back said the pharmacist was working on the prescription right then (uh, huh), got my credit card information and that was it.

The two bottles of progesterone arrived last Thursday in separate envelopes). First of all, the prescriptions were labeled as being filled on 9/5/2012 (Wednesday), so by the time I called the prescriptions had been filled for two days. Why lie about something so easy to catch? Wouldn't it be just easier to say "ooops, I'm so sorry we didn't call you, let's get this taken care of right away!" I'm so sick of the compounding pharmacies lying over stuff that any patient with working brain cells can figure out!
The minute I looked at the label (always, always check your hormones/meds as soon as they arrive or before you leave the pharmacy!) I knew the directions were not written out the way I know Dr. Carr prescribes progesterone, and I quickly went to check what my old bottle of progesterone said (the one from Town Center). That bottle says:

Apply 1 gram (1/4 tsp) four times a day.

In the past, most of the prescriptions have said "...4 times a day to forearms." I've taken the bioidentical progesterone for 6 years, and so I know how to administer the hormone.

The bottle from Greenfield says:

"Apply 1/4 teaspoonsful (sic) 4/days as directed by MD."

This bothers me greatly, because I think these directions could very easily be misinterpreted to make a patient think they only needed to take the progesterone for 4 days, not 4 times a day. Big, big difference. I emailed Dr. Carr to give him a heads up, and he contacted the pharmacy. I intend to write to the pharmacy (they don't have a website that I can locate) and also express my concern.

Bottom line: if you are starting with a new physician, hormone specialist or any other healthcare provider, make absolutely sure you clearly understand how much (also should be noted that there were no measuring spoons with this order of progesterone, and the applicator they sent with the bottle is useless and confusing), how often, and where the medication should be applied. I've seen numerous instances of mix ups in this area----one woman was putting her testosterone on right on top of her progesterone, thus effectively cancelling each other out, another woman had no idea how to open the bottle of progesterone to correcly dose (she was exposing the progesterone to more air than necessary), and a third was way overdosing on testosterone. In every instance (and there are many more I could cite) this was a clear lack of communication somewhere in the triangle of healthcare provider--patient--compounding pharmacy. If what is written on the bottle of hormones/medication does not absolutely, exactly match up with what you were told by the doctor (or what you understood from the doctor)---do not hesitate to call the doctor's office, ask to speak with a pharmacist, or both. This is your health you are dealing with, and worth the effort to check and double check.

On the upside, I tried the new progesterone and the quality seems to be fine, it rubs well into my arms and does not have the shredding issue I had with the batch I used this summer from Town Center Pharmacy. Their response to my conerns about the label instructions will determine my future association with them.

Sunday, September 9, 2012

Menopause Evolved To Limit Competition Between Older Women & Daughters-In-Law, Study Suggests

Since I have neither been a daughter in law or a mother in law I will abstain from commenting on this article from The Huffington Post. I thought it was interesting, however, and want to share it with you.

Utah jury orders drug companies to pay woman $5M

In the continuing saga of women suing Pfizer (they bought out Wyeth Pharmaceuticals, the original makers of Premarin and Prempro) and winning a large jury verdict. Check out the details from 10TV.com.

Friday, September 7, 2012

Study sheds light on why women gain fat following menopause

Menopausal weight gain is so frustrating for women (me included, I've battled weight issues my entire life.) There actually is something to the theory that the decline of estrogen (along with a number of other factors) does affect weight gain in women going through the menopausal transition. Check out this article from Medical-News.net, and pay particular attention to the first paragraph of the second page (and yes, I am aware that the article is a little dense for those of us who are not medical professionals!)

Monday, September 3, 2012

Menopause Awareness Month

Yes, it really exists! If you are reading this blog, I am going to assume you are already aware of menopause (perhaps painfully so) but if you want to be "official", check out this link to the website for Menopause Awareness Month!