Bat-shit craziness – hormone therapy revisited

I had a hysterectomy in July 2013, a necessary procedure that has ultimately ehanced many aspects of my life. In my case, the positives are many and the negatives … until recently I did not really feel like there were any negatives. Once my recovery was completed, the staples removed, and I was freed to return to driving myself after two weeks, I have felt mostly good and better much of the time. However, on the advice of female friends who had been through this, several months later I visited with my doc to talk about hormone replacement therapy and whether or not it was something for me.

But first a word about my primary doctor and his practice. While he is a general practitioner, he operates a concierge medical practice and through the years it has evolved into a practice that focuses primarily on aging gracefully and preventing, curing, or at least alleviating the ailments that being creeping up on us as we age. Of course he still deals with general health issues – coughs, colds, flus, wellness, etc. – but this level of practice is not going to find a lot of young and ailment-free young people in their first jobs. When I initially started with him several years ago, his business model was to limit his practice to 500 clients and offer them virtually unlimited access and personal service. Whether he has 500 or 5000 clients is irrelevant to me. I have never had an issue getting an appointment the same day or the next day at the very latest, and if there have been occasions when he’s called in a prescription for me based on a description of my symptoms and how crappy I felt. These days I do not see that often – my diabetes has become complex enough that I have an endocrinologist taking care of me for that – but anything and everything else I call my doc first and consult with him or his physician’s assistant directly. He’s fabulous and I am happy to pay his monthly fee to have this level of service.

I consulted them about 8 months after the hysterectomy, but I was still feeling good and decided I was not yet ready to embark on adventures with hormones. They were fine with my choice and told me to let them know if I changed my mind. Well … this summer I have been thinking about changing my mind. I keep attributing it to stress, but I’ve been slowly and surely exhibiting all the symptoms associated with hormonal imbalance. I have had weight gain. I have been anxious/irritable/depressed. I have had trouble sleeping. I have had fatigue. I have been forgetting things and having memory fogginess. Of everything on the list, the memory issues are the most troubling. Even here on the blog, writing posts or comments, I have to use the online dictionary or thesaurus more frequently to pinpoint the exact word I want and fears of early onset Alzheimer’s are starting to creep into my consciousness. My father was a lot forgetful by his 60s, but I have always attributed that to his unhealthy drinking and smoking habits. My mom was probably in her mid-70s before her memory started been sketchy, but I’m just over 54 and this symptom alone has put the hormone issue into my mind. M oh-so-gently suggesting it has elevated it to a thing to investigate further.

After Sunday, when I had a total scorched earth screaming mimi meltdown with M over household crap, I knew it was time to have a real conversation with my doc about hormonal imbalance. Yes, work has been stressful, the budget impacts serious, but nothing else in our life rates that level of tantrum and shitting on my husband I went through on Sunday. Into such conflicts there are always shades and facets of truth, but the level of resentment and anger I displayed was so over the top and dialed-in to cause maximum hurtfulness like a heat-seeking missile was completely inexcusable and makes me cringe just thinking about it. M is definitely the bigger man in forgiving and suggesting I need medical intervention rather than retaliating with equally hurtful barbs directed right at me.

So I saw my doc. And I have hormone matching prescription cremes en route to me from the pharmacy. And a couple of additioanl OTC supplements to help me feel more better, to be all I can be. For six weeks, anyway, until I take the spit test and measure my levels and adjust the prescription as needed.

What is the “spit test” you wonder? This kind of grosses me out, but apparently the hormone level measurement test is done by filling tiny little vials with saliva 4 times daily and then mailing it off to the laboratory for analysis. Gross right? But I digress. They do not test me in advance because I am ovary-less and therefore hormone challenged right out the gate. The question becomes whether the minimum hormone matching dosage is adequate or if the amount will needed to increased to achieve optimum results. I will go to the vitamin B shot clinics once a week, because that should help with my overall energy levels. I hate the shots – they sting and then I can taste the vitamin taste immediately afterwards – but it seems easier than taking them daily and having that taste directly in my mouth.

Overall, I feel good about it. I’m glad I went to see the doc, I’m glad I am doing something to take better care of myself. The changes will be subtle and happen gradually, but I am truly hopeful and believe they will happen for me with time and consistency. Maybe it will also help me with my reluctant acceptance of the need to exercise. A girl can hope.

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