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

Sunday, July 28, 2013

Hot Flash Diaries Unreliable

A number of women have told me that their doctors have asked them to keep a "hot flash diary", in other words, track the number and severity of their hot flashes in a 24 hour period over a period of time (couple weeks, months, whatever.)  They then take the diary into their doctor and supposedly treatment options are at least in part considered on a woman's "hot flash history".

A University of Pittsburgh study (check out this article from ThirdAge.com) suggests that this method of tracking hot flashes and/or night sweats is ineffective, and that women often under report the number and severity of their hot flashes, or over report the number of night sweats.

I'm not at all surprised that self reporting systems are inaccurate in these situations for several reasons:

  • It's well known that peri/menopause can cause cognitive issues.  Before I got my hormones balanced, I couldn't remember what I had for breakfast, never mind the number of hot flashes I had in a day (and it was at least 20.....which isn't unusual.)  Can you remember 20 of any incident in the course of a day?  
  • Night sweats (which oddly enough, was one of the few symptoms I didn't have).....night sweats can cause huge, exhausting disruptions in sleep, and trying to accurately report anything when you are sleep deprived is like bailing out the ocean with a Dixie Cup.  
  • Peri/post menopausal women generally have very busy lives, work, home life, raising kids, often caring for elderly parents..........do you seriously think they have time to think back and accurately record their hot flashes at the end of the day?  In a journal?  I do everything on the computer. 
  • A lot of women either suspect or know that even if they keep a scrupulous record of their vaso-motor symptoms (fancy term for hot flashes), their doctor is not going to take them seriously.  The doctor may have already announced his/her bias against hormonal treatments, which, unless the patient seeks care from a physician who is knowledgeable about bioidentical hormones, leaves fans, air conditioning, loose cotton clothing, sucking it up, or antidepressants, none of which get to the root of the problem (hormonal imbalance) and in the case of antidepressants, can make a bad situation worse.  Think about it, one of the side effects of most antidpressants is excessive sweating, so giving an antidepressant to a woman who is having hot flashes................
In an almost totally unrelated topic..........did you know that Fudgesicles have only 40 calories?  I've been a fan of them since I was a kid (although I will tell you they don't taste anywhere near as creamy as they did back then), and I keep a box in the house year round for "chocolate emergencies".  I just finished one before I sat down to write this post.  Thought I would share that with you in case you want something a little sweet without going too far off the course of healthy eating!

Hope everyone has had a good July, hard to believe on Thursday it will be the first of August.  We've had a very, very wet summer here in NC, areas just west of us had a foot of rain in less than 12 hours Friday into Saturday, widespread flooding and damage.  Let's hope Autumn is bright and beautiful!

Sunday, July 14, 2013


Good morning, everyone, wanted you to know I have not forgotten you.  I had a flare up my back spasms on Friday (I swear, I was really doing ok, went to the gym to do my back strengthening exercises and everything!).  I got in the shower about 5 pm, bent down to put some sugar scrub on my heels, and wham------the spasming started.  It was awful, took me 20 minutes to get dried off and into my jammies and sit on the bed.  I was finally able to get to the freezer a little later for a large ice pack for my back (to relieve the inflammation), and laid very still on my back in bed for quite a while.  For the firs 24 hours I could only take a very few steps, painfully, using my cane.  Today as I write this (Sunday noonish), I am better, still painful but not like it was. I am up walking every hour to stay as mobile as possible, and if one of my swimming buddies is available later, I would like to get in our condo pool and just walk around for a few minutes to stretch and stay limber.

Other than the fact I still need to lose more weight, I really am doing the right things for taking care of my back, I'm aware of ergonomics, I do back strengthening exercises at the gym, I swim/water aerobics (good for core strength), take fish oil to hold down inflammation, Vitamin D for bone health (along with my hormones), I stretch daily, and so on.  Sometimes these things just happen, frustrating as that is.  I am super blessed to have great friends taking care of me; one sent her husband yesterday to stock my house with groceries (that was on my Saturday morning to do list, wouldn't you know), and another friend brought me dinner, a yummy bagel to snack on, and spent several hours keeping me company yesterday! Other friends have been checking on me.  I'm going to nap this afternoon, but try to stay awake as much as I can otherwise so I sleep better tonight.

I am (hopefully) going to go through my newsfeed today (fortunately I have an iPad so I can do computer stuff laying down) and see if there are any good hormone/menopause articles to share with you, and I will mark them and post them this week.  Getting very hot here in the Southeast, as I know it is in other parts of the country, so please make sure to stay hydrated (another tip recommended to alleviate muscle spasms, you better believe I am sucking down water like crazy!) and keep cool as much as possible.

See you soon!

Tuesday, July 9, 2013

Tuesday, July 2, 2013

F.D.A. Approves a Drug for Hot Flashes

Good morning! I hope everyone is enjoying this first week of July.  I know many of you on the West Coast are struggling with very hot temperatures, and in the Midwest and East Coasts, many of us (NC included) are dealing with severe thunderstorms and some flooding. I saw pictures of cars under water near where I grew up in Central New York, and here in NC, we have been dealing with localized flooding for a couple weeks now. Last Friday night, the community where I live got 6 inches of rain in less than three hours!  We are fine here, but some of the back roads were washed out near here.  We've had much less sun than we normally have in the summer, too, and usually by now I have decreased my Vitamin D daily supplements from 10,000 IUs daily to 5,000 IUs because I am out in the sun swimming in our subdivision pool.  Not this year, I barely have any colour at all......most of the days I have been out have been very cloudy and I've even worked out a couple times when it has been raining.

I saw this article in the NY Times, and it made me furious.  It's a great example of how messed up the FDA is, and how truly little regard the agency has for the health of the American public.  Back in the spring, it was reported that a committee that advises the FDA had voted (by a wide margin) against approving the drug Brisdelle for hot flashes.  The active ingredient in Brisdelle is the same ingredient in the anti-depressant Paxil (generic name paroxetine).  The committee felt that although in clinical trials the drug did reduce the number of daily hot flashes of the study participants, patients receiving a placebo also experienced almost as much improvement in the number of hot flashes, and the risks associated with Brisdelle outweighed the potential benefit.  Despite the committee recommendation, the FDA decided to go ahead and approve Brisdelle anyway, and it will be on the market later this year.

Here's a list from Web MD of some of the side effects of Paxil/paroxetine.  I took Paxil for a number of years (before I got my hormones balanced)  for depression issues, and I experienced a number of the side effects listed in the link above.  The sixth one listed, excessive sweating------yes, I experienced that in spades!  Great side effect for someone who is already experiencing hot flashes.  Drowsiness, trouble sleeping, head pain, weight gain (I gained 25 pounds taking it),  nervousness, don't these all sound like symptoms of hormonal imbalance/menopause?

This comes down to the FDA being in bed with the pharmaceutical companies, and putting the safety of patients way down on the list of priorities.  The excuse of the 2002 study (referenced in the article) about the safety of hormones is a tired and quite honestly absurd argument, the hormones used in that study were NOT bioidentical.  I know I have said this repeatedly, but instead of filling patients up with toxic medications with marginal effectiveness and significant side effects, doesn't it make more sense to just replace (bioidentically) the hormones that were in the body in the first place that we lose as we age?  I am ever grateful for Dr. Carr and other progressive physicians/healthcare providers that can use logic and common sense to see that hormonal balance to treat the underlying problem is far safer and more effective than just handing a patient a prescription to mask a symptom.

As always, talk to your healthcare professional about this, and NEVER, and I mean NEVER, go off any medication cold turkey ---------ALWAYS wean from any medication under physician supervision.

For those in the US, Happy 4th of July!