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!

Ouch!

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!

Please watch this video-------

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!

How Estrogen May Help Prevent UTIs After Menopause

I'm guessing that a lot of my readers can relate to the problem of recurrent urinary tract infections, particularly in the peri/postmenopausal stages of life.  The infections usually cause frequent and/or painful urination, and can cause significant pelvic discomfort.  The usual treatment is antibiotics, and from many women I have talked to, they end up on antibiotics several times a year, if not more often.  The antibiotics can  have a whole range of side effects, and it's important to note that after a number of courses of treatment, the body can build a resistance to the antibiotics, and stronger antibiotics have to be used.

I think a better approach is to address the issues surrounding why so many peri/post menopausal women get frequent urinary tract infections in the first place, and one of those reasons is the genital and urethral tissue becoming thinner and more fragile with the loss of estrogen.  Most peri/post menopausal women notice vaginal dryness and/or atrophy as they age, but are often too embarrassed to talk to their doctor's about it (and we will address that in a separate post!)  This is not just a matter of sexual health (although that is very important) but about urological health.

A study detailed on WebMd.com discusses using vaginal estrogen in post menopausal women to alleviate the deterioration of the genital tissue.  The article is not specific as to whether bioidentical estrogen was used, and if so, if the estrogen used was estradiol, or the weaker form of estrogen, estriol.  I have taken estriol cream vaginally for about 5 years (and writing this post reminded me that I need to call the pharmacy to order more!)  I have not had a urinary tract infection in years, and I attribute that post menopausally to the estriol cream.  I have it compounded, and it's about $100 for a three month supply.  Not having to be on antibiotics (I haven't been on an antibiotic since 2007, and that was for a bug bite I scratched too hard in my sleep!) is wonderful.  Ironically, when I was younger, I was one of those women who used to get a vaginal infection every time I was on an antibiotic (which was frequently, I taught high school and spent much of every winter battling upper respiratory infections and strep throat).

Talk to your doctor about using bioidentical estrogen for vaginal dryness/atrophy.  I have a couple good articles to share with you, so hopefully I will be able to post several times this week.  Happy first full week of summer!

54 years ago today------

Yep, today is my 55th birthday! My fifties are turning out to be my best decade yet, and the bioidentical hormones have had a great deal to do with feeling so good and strong.  Yeah, the chocolate obsession goes waayyyy back :)  I'll be back later this week with a real post, but today I am taking it easy (although I did hit the gym this morning!)  Having a celebratory dinner with friends tonight, and several more celebrations to come!

Progesterone and Brain Health.......

For the past several years, studies have been conducted to gauge the effect of using bioidentical progesterone on patients who have suffered a traumatic brain injury (fall, car accident, other causes.)  Naturally, as someone who takes bioidentical progesterone herself and has seen a significant increase in my cognitive function, I have taken interest in these studies. It is my hope that someday progesterone therapy will be a mainstream medicine standard for treating traumatic brain injuries.

One of the important facets of this treatment protocol is using the progesterone as soon as possible after the brain injury to minimize the damage.  This, of course, presents a challenge to healthcare practitioners, because consent for treatment, particularly in clinical trials, is vital. I was in an experimental medical protocol trial once, many years ago, and it was related to a medication that may or may not (never knew if I received the medication being studied or a placebo) have been administered during a reconstructive knee surgery.  I remember that the medication being studied was supposed to help relieve nausea post surgery, and that pre-operatively I had to sign a boatload of consent forms. For the record, I was wildly sick to my stomach for 24 hours after the surgery.

Because patients with TBI are often unable to consent to participating in a clinical trial because they are incapacitated or unconscious, obtaining consent is often difficult to impossible.  The Boston Globe has an article on their website detailing the dilemma of getting consent for the progesterone and TBI study being conducted at Boston Medical Center and Massachusetts General Hospital.  I hope the researchers are successful in finding a way to navigate the laws in place, because this is an important study that could affect patients of all ages.

If you would like to learn a little more about how progesterone affects brain health, be sure to read this article from Virginia Hopkin's website, she is a terrific resource for information about bioidentical hormones.  Be sure to sign up for her newsletter!

Levoxyl recalled, may be unavailable until 2014

Damn.  I was sure I had posted about this back in April, but if I did the post disappeared because I do not see it on my newsfeed.

I take Levoxyl (brand name) for T4 hypothyroidism.  Dr. Carr always orders brand name Levoxyl instead of generic because of its efficacy and consistency of dosage.  I went to refill my prescription today and found that because of a drug recall by Pfizer (article link is to Endocrine Today), Levoxyl in any dosage is not available at this time, and the drug may not be available again until 2014.  I am NOT a happy camper.

I know many of my readers also take Levoxyl, so it affects a lot of us.  If you are taking brand name, you need to speak with your doctor's office to find out about alternatives until this gets straightened out.  The generics work for some people, others have had heart palpitations (usually brief).  I'll keep you updated on how I will be dealing with this medication issue, but as I always remind readers, check with your doctor before making any changes in your medication or supplement regimen.

Depomed Fails to Win U.S. Approval for Menopause Drug

Good morning, everyone, and thank you for your patience! I got away from posting for a few weeks for a couple reasons.

1. Life. I am making some big changes in my life, and while they are positive changes, the steps involved have pretty much consumed me for the last 6-7 weeks.  I'm still transitioning, but making progress. Details to come!

2.  A lack of any newsworthy items on menopause/hormones lately.  Sometimes the news is filled with information about health studies, new ideas, and sometimes it's not.

I was not at all surprised to see this article Friday in Bloomberg News.  I wrote about this drug (Sefelsa) back a few months ago, it is a form of Gabapentin, which some of you may be familiar with as Neurontin.  I actually took Neurontin for about 4 months a number of years ago (pre-bioidentical hormone balance) for chronic pain issues, but it didn't help me with pain management.  I was perimenopausal at the time, and I know it did not help me with hot flashes (believe me, I would have remembered if it did!)

Hot flashes are caused by a hormonal deficiency, NOT a Neurontin deficiency, and not an anti-depressant deficiency.  I know my regular readers have heard me say this a number of times, but three days after I started bioidentical progesterone cream, I had no more hot flashes. None.  When articles like this use phrases like a "non hormonal alternative", I read that to say "instead of just replacing in your body the hormones that you had as a younger woman (or man) but lose as you age, we would rather fill you up with expensive, possibly toxic medications-----let's not bother treating the underlying cause of your medical problem, let's just give you drugs to mask the symptoms."   It makes me (and many other patients and their physicians) just crazy.

Stress study offers clues for new antidepressant drugs

Until I became a patient in Dr. Carr's practice in NC (before he moved to CA), I had a number of doctors, including a boatload of assorted specialists relating to the injuries from my long ago car accident, and not one of them ever spent more than about 60 seconds talking to me about stress.  I didn't even know what cortisol (the stress hormone) was until I started seeing Dr. Carr, and I sure didn't know what an important role it plays in our overall health.

My cortisol levels are now checked on a regular basis.  My levels are likely always to be somewhat elevated because: a) I deal with chronic pain, which stresses the body, and b) I have dealt with lifelong anxiety and depression issues, which also put a strain on both body and mind.  My depression and anxiety are far better now that I am hormonally optimized, but it is and likely always will be a work in progress.

Dr. Carr has told me more than once that optimally, the cortisol level should be about 10 or under.  Mine at last check was 10.9, which I consider to be a major accomplishment!  Two years ago, my cortisol level was 19.7, and in the time since, I have made major, deliberate changes in effort to get the levels down.

I detailed a serious bullying issue (yeah, that actually happens to women our age) in a previous blog post.   At the time that all of that occurred, my cortisol level was hugely elevated, and since getting those awful women out of my life, my cortisiol level has dropped nearly in half.  Those women really were making me sick!  An interesting footnote to the story......since that blog post was written, one of the women involved in the bullying tried to reconnect with me though a mutual friend.  I emailed the woman directly and told her in no uncertain terms that my life was richer and more meaningful than a year and a half ago, and that my self respect left no room in my life for people who went out of their way to hurt, humiliate and ostracize me the way she and her friends did.  It's a closed chapter in my life and I am very much at peace with the way I handled it.

I've taken steps to step out of the routine once in a while and really "play".  I budget to do it so it doesn't cause financial stress, but I consider it an important part of my overall health.  My last "mini-vacation" was doubly the fun because it came up unexpectedly.  I got a last minute ticket to see Barry Manilow (go ahead and laugh, he was hot when I was a teenager!) in Raleigh, and I spent the night at a hotel right across the street from the concert venue.  I drove up early in the day so I could rest my back in the afternoon, and being so close to the venue I didn't have to leave to go over to the concert until close to curtain time. The show as WONDERFUL!!!!  Barry's still got it :), and I had a blast.  The next morning, I happened upon a really great arts and crafts festival in a beautiful park on a beautiful day.  I had to use my cane to get around because my back was pretty painful, but it was more than worth it.   Two of the best days I've had in a long time, and a great way to celebrate spring.   I make a concerted effort to get together with friends that I am comfortable with, people I can laugh and be silly with.  I also make time to pursue my hobbies of knitting (it's really a great stress reliever, and I have used it for years to manage pain levels), reading (and you can immensely cut down on the cost of that hobby by availing yourself of library resources), and I have recently become interested in Zentangle.  I can't overemphasize the importance of having a passion.  I also work out regularly, cardio, interval training, light weights.  It's good for the mind and body.

I also take supplements to manage my cortisol levels.  In the morning, I take Adrenevive and at night I take Cortisol Manager, both have played a crucial role in managing my stress.  I also meditate, although I must admit I am not as consistent with it as I would like to be (but trying not to stress over that!)

I ran across this article in Reuter's this morning, that a study has been done on the effect of cortisol level on brain cells.  The article talks about how the information learned in the study can help develop new drugs, specifically antidepressants, in the future.  Wouldn't it make more sense to spend some of those resources on bioidentical hormone optimization, educating patients on ways to reduce stress, and studying the importance of supplements in managing cortisiol levels?

Take some time to really think through ways to manage the stress in your life. If you have a chronic pain issue in your life that is not being addressed, see your doctor about it.  I am blessed to have a pain management physician who understands the mind/body connection and is my biggest cheerleader in my efforts to manage my cortisol levels.  If there are people in your life who are making you crazy, get rid of them or find ways to minimize your contact with them.  If you are over scheduled, prioritize and delegate.  I learned a long time ago to stop being general manager of the universe.  Be a supportive friend and cultivate healthy relationships.  Don't take on and try to solve all your friend's problems, I've already tried that and it doesn't work.  Most importantly, be your own best friend. Stop beating yourself up (and you know you are doing it !).  Work on being at peace.

The Compounding Pharmacy Debate..................

Many patients, me included, get at least some of their bioidentical hormones from compounding pharmacies. I get my progesterone cream, my estriol cream (for vaginal atrophy) and my T3 capsules compounded.  My estradiol and testosterone are purchased at my local big box store pharmacy. I inject both of those medications once weekly (for me, Sundays), and I have found that it is easier to keep my hormone levels optimal with the protocol I am on.

I know most of you are aware of the fiasco and many deaths from tainted injections made by the New England Compounding Center last fall.  Clearly the ball was dropped in regard to oversight over this pharmacy, which was not acting as a compounding pharmacy, but as a manufacturer, thus stepping way over the lines of what they were supposed to be doing.  It frightened (justifiably) many people, and I spent a couple months reassuring patients from a patient's point of view that this was an aberration, that this is NOT the way most compounding pharmacies do business. I have NEVER had a problem with any of the hormone creams I have taken, and I have used at least five different pharmacies over the course of the last  6 1/2 years.

There is much discussion in Congress right now about whether or not the FDA (Food and Drug Administration) should be given broader access to regulate compounding pharmacies, which now are under the control of state pharmaceutical boards.  I will be the first to tell you I am not a fan of the FDA, I think they are in bed with Big Pharma and have done a great deal to harm our health care system.  A couple of years ago, I read something in an article that really struck home "Remember that every drug recalled by the FDA has first been declared safe and effective by the FDA".  That's important.

Do we need to make sure that another rogue "compounding pharmacy" doesn't get greedy and decide to make oodles of money by stepping over the line to become a drug manufacturer instead of a compounding pharmacy? Sure do.  Does giving the FDA broad but ill defined power the answer?  Read this article and an opposing opinion from USA Today to help you decide.

Uterine Fibroids and Vitamin D

I've been doing this blog for about four years now, and the more women I talk to, the more I convinced that there are less than two dozen women over the age of 50 who still have their uterus.  I'm kidding. Sort of.  The number one cause of hysterectomy in women  is uterine fibroids.  I had a hysterectomy in 2002 for fibroids; they weren't huge but caused a lot of pain, and the bleeding was so heavy (and erratic) that I became severely anemic.  I had to have 8 weeks of iron infusions by IV (3 hour sessions---ugh) for 8 weeks preoperatively just to get my blood levels high enough to be cleared for the surgery.  What was supposed to be a 24 hour hospital stay post operatively ended being 8 days----I bled post operatively necessitating a second surgery, and then developed a urinary tract infection from the catheter.  Not my idea of a great time.

In the NY Times, I read about a new study out that suggests that a low level of Vitamin D increases the risk of uterine fibroids in women.  I was interested to see that the risk of fibroids was reduced even when a woman's Vitamin D level was as low as 20------even by the ridiculously low standards of mainstream medicine, a level of 20 ng/ml is considered insufficient.  Some mainstream (read that to mean old school) physicians consider 30 ng/ml to be "adequate:", but more and more doctors are striving to get their patients up to at least 50 ng/ml.  Dr. Carr (my physician) likes his patients in the optimal range of 70-100 ng/ml, and my last reading in February came in at 78.  I often get asked how much Vitamin D I take.  Right now I am taking 15000 IUs daily, 2 - 5000 IU capsules, and then I get another 5000 IUs in the L-Arginine powder I take daily (it's a supplement, has a lot of benefits including heart health, but also contains Vitamin D).  The brand of capsules I take is Ortho Molecular, I cannot stress enough the importance of taking a good quality supplement.  I ran out one time, and being lazy (and distracted, I forgot to add it to my supplement order) I picked up some at a big box store and took it for about 3 months.  When I had my blood work done, my Vitamin D level had dropped by about 10 point.  Vitamin D is not an expensive supplement, and the Ortho Molecular brand (I have also used Integrative Theraputics) is just about the same price as the drug store brands.  Now that we are (finally) getting into warm weather, I will be out in the sunshine more, and at the end of this month I will drop back to taking one 5000 IU capsule and my L-Arginine.  I swim outside about 5-6 days a week in the summer without sunscreen, so I get a good dose of Vitamin D courtesy of the NC sunshine!

If any of my readers are from the Boston area, my thoughts have been with you this week, and I am very glad they caught that second terrorist suspect alive.  I watched some of the coverage yesterday, but in my concerted effort to reduce my stress level, I didn't focus on it and went about my day and stayed as busy as I could.  Yesterday my back was really painful, so I had an in the house day (I refer to it as a play quietly day), I read, listened to music, did a little Zentangle artwork (I'm finding this a great way to meditate!), knit for a while, and did some gentle stretching every time I got up to move around.  My back is definitely better today, I am being careful not to sit for very long at a time, and thank goodness for my iPad to browse online when I am laying down resting.

Hope wherever you are and whatever you are doing, you are having a great weekend!

I haven't forgotten you------

But lately, there has been little news to share in the world of bioidentical hormones and related menopause issues.  I hope everyone is enjoying these first weeks of spring, which have been very slow to come to the Southeast. It's finally here, however, and I have been enjoying some beautiful, sunny, mild days, perfect for capri pants and sandals!  Luckily, the progesterone cream keeps me allergy free, but lots of folks around here are sneezing and have very itchy eyes.

Hard to believe tomorrow is tax day..........the month of April is half gone! I'll be back soon as soon as I have any good articles to share with you, in the meantime, enjoy the rest of your weekend!

Osphena

The FDA has recently approved a new drug for peri/menopausal women called Osphena.  It's an oral drug that acts like estrogen on vaginal tissue, easing symptoms of thinning of the vaginal tissue, and the dryness that often causes sex to be painful or impossible.  Here is the FDA's press release about the approval of Osphena.

This drug is a perfect example of women getting screwed over by the pharmaceutical companies.  Bioidentical estriol cream  has been used for many, many years to treat vaginal atrophy. Estriol is the weakest of the three estrogens, and in a vaginal cream (compounded) is even used in  women who have been treated for breast cancer.   But because estriol cannot be patented, the drug manufacturers don't want to hear about it (or have women hear about it).  Doesn't it make more sense that if a woman is having a problem with vaginal dryness, that you give her something to put in her vagina rather than in her mouth?  I didn't even go to medical school and it's clear to me that topical treatment, replacing what the body has lost with age, makes more sense than giving an oral medication that has unwanted side effects.  I almost choked when I read that some of the side effects of Osphena are thickening of the uterine lining (that's because mainstream medicine hasn't figured out yet that women need progesterone too!), and hot flashes/excessive sweating.  Really?  Are you kidding me?

I've taken bioidentical estriol cream vaginally (at night just before bed) for more than five years, and it works fine.  It's relatively inexpensive (I think about $60 for a two month supply), and has no side effects.  If you are having an issue with dryness and/or painful sex, talk to your doctor.

Still very few signs of spring here in NC, as in much of the country.  Usually by now I am full time into capri pants and sandals, not this year!  I had a wonderful girl's day out with a friend on Saturday, lunch and theater (we went to see the national touring company of Wicked----it was amazing!) and I wore a sweater and a shawl.  I'll be glad to see April arrive.  Have a great week!

One in three elderly have dementia when they die

I think many if not nearly all of my readers are affected by this report in today's USA Today.  Many of us are now or have had to care for elderly parents or grandparents, and far too many of our elderly loved ones have suffered from some form of dementia or Alzheimer's disease. I have a friend who lost her husband just about a year ago from frontal temporal dementia (at the age of 63, he developed the disease in his late 50's), and it was utterly painful to watch the progression of the disease and how it affected the entire family.  I feel truly blessed that although my mother was an invalid the last few years of her life, her mind was (very) sharp until the morning she died.  I'm not sure I could have kept her at home if dementia or other cognitive impairments were an issue along with her physical frailties.

I can't say that I know that bioidentical hormone optimization is cutting my risk for developing dementia in my later years, but I feel like better health at the cellular level, as well as keeping my hormone levels optimized, exercise, and keeping my mind busy and engaged are all helping in the fight.   For those of you who are currently taking care of loved ones with dementia and cognitive issues, my thoughts are with you.  It's a very difficult thing to endure, but please try to remember to take care of yourself too.  As my doctor told me when I was taking care of my mother "you can't pour from an empty pitcher."

Happy Spring starting tomorrow! It sure won't feel like it here in NC, we have had a cold, cloudy, miserable winter.  Today is the lone seasonal day of the week, tomorrow the high here will barely reach 50 degrees, and that is nearly 12-15 degrees below average. Boo, hiss.  Make it a great week!