"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!