Shmirshky Page 3

  The hypo symptoms were me to a T, especially the increased sensitivity to cold. Wow! For years, I had complained to my previous doctor that my hands and feet were constantly cold. He continually told me not to worry, that I just had poor circulation. I cannot believe that I walked out of his office every year comfortable with that answer, comfortable living with freezing feet. Since when was bigmouth me such a wallflower? Remember, shmirshkies are great at the cover-up. To problem-solve, I covered up my freezing dogs with the heaviest, warmest thermal socks I could find. I even wore those beauties to bed every night. Did I mention I lived in Arizona at the time? I know what you’re thinking: who wears thermal socks to bed when it’s 110° outside? All I can say is thank goodness David didn’t have a foot fetish!

  In my research, I learned that it is recommended for anyone with a thyroid imbalance to have a yearly ultrasound scan17 of the thyroid gland in order to detect nodules that may have gone unnoticed by a physical exam. These nodules can be cancerous. This was an important test, and I wanted to be sure not to forget to ask for it.

  I arrived at the specialist’s office with my ultrasound sticky note in hand. He did a physical exam of my thyroid gland and said he was going to put me on medicine that would bring my TSH back down to normal. I told him that I wanted to have an ultrasound of my thyroid as well, but he insisted I didn’t need one because he didn’t feel any nodules. I guess he thought he had magic hands, but that wasn’t going to cut it for me. I stressed that I was very proactive about my health and wanted the scan as a precaution, thank you. My gut told me to get this test. This was (and still is) my body and I get to decide! He was very annoyed with me, but I wasn’t leaving his office without an order slip for the scan.

  Guess what the test results revealed? I had a nodule on my left thyroid lobe. It took great restraint for me not to tell him where he could shove those magic hands.

  If you’re intimidated by your doctor, find yourself unusually afraid to speak up, or feel you’re not being heard and respected, then consider finding another doctor. Remember to listen to your gut and do not settle. Do not be afraid to change your doctor. It’s not like getting a divorce; a lawyer is not required.

  Needless to say, I found a new endocrinologist, one who is very well respected in the medical world, conservative, and a good listener. After a biopsy and eventually surgery, we discovered that the nodule was benign.18 Still, I have to stay on my meds to keep my thyroid balanced.

  shmirshky party alert!

  Maria’s mother and two sisters all have hyperthyroidism19 (remember, your susceptibility can be hereditary), and when she told me about her sister’s traumatic experience, my heart just sank. “My forty-five-year-old sister was in such denial about her symptoms that she waited to get help until she was unable to carry her groceries up to her apartment without resting in between steps. Unfortunately, she waited so long that—along with other permanent long-term side effects like hair loss and bulging eyes—she suffered heart damage and needed a valve replacement.” The consequences of the “I’m fine” mentality can be severe and sometimes irreversible.

  Even after her sister’s traumatic experience, Maria didn’t associate her own symptoms with what her sister had gone through. At forty-four, Maria started experiencing a huge metabolism shift. She lost thirty pounds in six weeks—can you believe that? She suffered from extreme fatigue, a racing heart, and tremendous night sweats. Maria was accustomed to swimming one hundred laps a day, and suddenly she was struggling to catch her breath after just one. She thought she might be experiencing PM&M symptoms and was determined to be “fine,” but as the days progressed she became increasingly edgy, paranoid, and angry. She just couldn’t live like that anymore.

  After eight weeks of suffering, Maria finally broke through the cover-up and called a doctor. (Hallelujah!) With the help of a wonderful endocrinologist, she was diagnosed with hyperthyroidism, received radioactive iodine treatment (RAI), and is now on thyroid medication, which requires periodic monitoring. Thankfully, Maria was properly diagnosed before any permanent consequences set in.

  Dramatic hyper/hypo stories are common among PM&M shmirshkies. If it doesn’t affect you, odds are it is affecting a shmirshky you know and love. Ultimately, we all have to take responsibility for our own well-being. Learn your family history and get yourself in to see a doctor if you are experiencing persistent symptoms.

  CHAPTER 10

  not-so-hot flashes

  As my thyroid numbers improved, I thought for sure that I’d be fine. Yes, being “fine” was my main goal. I didn’t have cold feet anymore (I was sockless!), and my energy level was much better, but I still couldn’t think clearly, nor was I sleeping well. In addition, new symptoms gradually began cropping up, or, should I say, dripping all over the place. I was hot!

  I began perspiring in strange places. Let me tell you, I will never forget my first flash. It was not hot outside; in fact, it was a beautiful spring day and I was wearing a lightweight pantsuit. All of a sudden, I felt a flush of heat come over me. When I rose from my chair, I noticed that something wet was dripping down the inner seam of my pants leg! No, I did not pee in my pants. I was perspiring! I am not kidding. Thank goodness I always carry a big purse. (I think big purses make my hips look smaller.) With my purse firmly planted in front of my shmirshky, I ran to my car. I looked down in utter disbelief. What in the world was this? Did I have a perspiring shmirshky? Did my shmirshky sneak off to the gym for a quick 5K while I wasn’t looking? I started signing my e-mails “HS (Hot Shmirshky) OMG!” Was I the only “HS” in the world?

  It was getting a lot harder to deny that I was in PM. It was sort of like getting stuck in the rain and telling people that it’s still sunny outside. You’re soaking wet—no one’s buying it! My body was dragging me into PM&M, and I did not want to go.

  One of the reasons I was able to stay in denial for so long was that I didn’t fully understand the sweaty symptoms of PM&M. I thought a PM&M hot flash happened when a shmirshky’s face got suddenly flushed. That is true for some, but not for others. While most PM&M shmirshkies get hot flashes in one way or another, we all experience them differently. We are a hot group! Some shmirshkies get them during the day, while others get night sweats. Some shmirshkies get them on their upper body, while others (like me) get them on their lower body. They can range from quick flashes of heat to super sweat sessions like the ones my friends Debbi and Patty endured (see chapter 8, “Sleepless in PM&M”).

  shmirshky party alert!

  One of my dearest Gay Husbands,20 Paul, told me a story about a business trip he was on to Switzerland in the dead of winter. One of his brilliant biotech executives was seated next to him when suddenly beads of sweat began dripping down her face. She was glistening in the reading light. Immediately, she began peeling off layers of clothes, one piece after another, until she was down to a sleeveless T-shirt. Later, during a highly sophisticated presentation to a Swiss venture capitalist, the dreaded flash appeared again. This woman did not strip down to her T-shirt during the presentation—though Paul was sort of afraid that she might—and not a word was spoken about the flash, as PM&M was definitely not on the meeting’s agenda.

  What’s a business shmirshky to do? Well, many PM&M shmirshkies find it helpful to pack an extra shirt or even a fresh outfit in their purse or briefcase. This might seem silly, but if you’re stuck in the Alps in the middle of winter and you’re sweating like it’s New Orleans in August, you’ll be glad you brought along a change of clothes.

  On the return flight home, Paul turned to his coworker and said, “You know you’re in menopause, right?” They talked about PM&M extensively and he offered his support. (Paul is quite familiar with the topic thanks to his Straight Wife—that’s me!) Good for Paul for putting PM&M on the agenda.

  Sharon told me that she doesn’t have hot flashes—she has night sweats. As any of the sleepless PM&Mers in chapter 8 would predict, Sharon would trade her night sweats for a flash in a flash! Without w
arning, she wakes up in the middle of the night covered in sweat. The first time it happened, she thought she had experienced a “great sex dream” but just couldn’t remember it. She made herself go right back to sleep, hoping she could plug back in to the orgasmic dream. It never happened. The next day Sharon shared her “sex dream” experience with her girlfriend, who was trying not to laugh as she explained to Sharon that this was “no dream, honey,” it was PM&M.

  My friend Lisa, age fifty-three, has a sexy new boyfriend. One night, after making passionate love, Lisa curled up in his arms, dozed off, and then suddenly felt hot—as she put it, “I know I’m ‘hot,’ but I also felt like I had a really bad sunburn.” She was “WET, soaking wet,” under her breasts and between her legs. The bed was soaking wet as well. She jumped out of bed, thinking she had urinated in her sleep. Lisa stood there, mortified, wondering how she was going to tell her new boyfriend that she had peed in his bed. It took her a few minutes to realize what had actually transpired, and in the morning she told her boyfriend about the incident. The first thing he said was, “YUK.” Lisa agreed, and they discussed the situation openly. I’m so proud of Lisa and her boyfriend for talking about this and not letting it get in the way of tearing each other’s clothes off.21

  Everyone’s experience is different. Some PM&M shmirshkies find that when they drink alcohol or hot beverages such as coffee and tea, their hot flashes are hotter and their sleep is even more restless! Of course, we all know that when you drink, you seem to eat more. This is not good for the already ever-expanding PM&M shmirshky. Don’t freak out too much, though, as not every shmirshky has sensitivities to alcohol. Thank goodness, because cocktail hour helps some shmirshkies open up and talk about PM&M, instead of hiding under that bush.

  Ultimately, it was these not-so-hot flashes that forced me out of hiding. I had to admit to myself that I was dealing with more than just a thyroid condition; I was beginning PM&M. That’s when my problem solving kicked into high gear.

  CHAPTER 11

  shmirshky in the basement

  I needed to read more about PM&M, and fast! So where does the layperson go for help? (What a funny term! The last thing I was thinking of was laying anyone!) Books are a great place to start. Some of them are hundreds of pages long. They can be very technical, very medical, and there aren’t any hot romance scenes to keep you awake. Keep reading anyway. This research is critical to understanding what’s happening to your body and will help ensure that you can communicate well with your doctor in order to successfully manage your own PM&M journey.22

  My first shmirshky recon trip was at a wonderful neighborhood bookstore. I walked all over the store looking for books on PM&M, but I couldn’t find a thing! Then I saw the basement. Yes, you guessed it—the PM&M section was in the basement. I guess PM&M is not cool or chic enough to be on the first floor. I couldn’t find any PM&M books on the Employees’ Picks table either. Shocker. I dragged myself downstairs and gathered as many books as I could hold (FYI, there are no stairs to deal with when you buy online!). As I stumbled back up to the cashier, I noticed that she was a young shmirshky. She gaped at me as she rang up over a dozen books on PM&M. I told her that I would read them all and let her know how it went. She laughed. I thought, oh man, you just wait.

  CHAPTER 12

  shmirshky private “i”

  It didn’t take long before I realized that I needed to find a great gynecologist who specialized in PM&M to help me with my sweat-stravaganza. Finding the right PM&M specialist is critical. This might not be the same doctor who delivered your babies or does your routine Pap smear. You may need to dig a little deeper to find a PM&M specialist who’s right for you.

  This shouldn’t be too hard. After all, shmirshkies are gatherers; we know how to find what we’re looking for, whether it’s a cute new top or the perfect gift for a friend. Unfortunately, many shmirshkies spend more time researching hotels, hairdressers, and restaurants than researching doctors. Have you ever chosen a doctor because he or she is close to your house? I know I have, yet I never simply picked the closest hotel to my destination; I would drive miles out of my way for the most fabulous place to stay. Remember, you’ve got to think inside the box! Use your finely tuned investigative skills to find a great PM&M specialist. Here are some tips to gathering good doctor recommendations (you can search later for a delicious bite to eat nearby):

  • If you know a great doctor who excels in his or her specific field, this is an excellent place to start. Great doctors often know other great doctors, and receptionists and office managers can usually get a recommendation for you. If you like your current gynecologist, ask him or her to recommend a PM&M specialist. There might be someone right there in the same office who specializes in PM&M.

  • Ask trustworthy friends and family for recommendations. I keep an ongoing list of different doctors who people recommend to me. Start keeping your own list, and then you’ll be a good resource for your friends as well!

  • Go online. The Internet is a massive medical resource. You can start by taking a look at the North American Menopause Society’s resources for finding a “Certified Menopause Practitioner.” Just follow these links for more information:

  http://www.menopause.org/compexam.aspx

  http://www.menopause.org/referralservice.aspx

  • If you happen to know a medical student, or know someone who does, pick his or her brain. Medical students often interact with a lot of doctors and might know of some great doctors in your city or town.

  • Use local media as a resource. In some cities and towns, a local magazine will dedicate a single issue to rating the top doctors in the area (in the Big Apple, New York magazine does this every year and provides a resource on their Web site year round). You can also check Web sites, message boards, and neighborhood e-mail lists for local recommendations.

  • Ask a lawyer. He or she might know someone who does medical malpractice defense. These people often know good doctors . . . or at least the ones to avoid!

  • Depending on what type of medical coverage you have, you might need to pick from a list of doctors who are covered by your provider. Be sure to cross-check the above resources with this list.

  Now that you’ve got a list of doctors in hand, it’s time to do some research. Here are a few good resources to get you started:

  • Google the doctor’s name and see what you can find. Often a doctor will have a Web site that provides some basic biographical information.

  • Visit your state medical licensing board Web site and search to verify that the doctor is currently licensed. If you can’t find the right Web site, go to the American Medical Association for a link to your state’s Medical Licensing Board: http://www.ama-assn.org/ama/pub/education-careers/becoming-physician/medical-licensure/state-medical-boards.shtml, or check the American Board of Medical Specialties Web site (this service is free, but registration is required): https://www.abms.org/WC/login.aspx.

  • Check out sites such as http://www.ratemds.com and http://www.healthgrades.com, where you can order a background check to see if the doctor has any malpractice claims against him or her and is in good standing with the state medical board.

  While you’re doing this research, think of yourself as a shmirshky private investigator at the center of a sexy espionage thriller. It’s always the middle of a hot summer in those stories, so your hot flashes set the mood perfectly. Put on a big-brimmed hat and speak with a 1940s New York accent, and you’ll be good to go. You see, looking for a gynecologist who specializes in PM&M can get pretty exciting!

  CHAPTER 13

  shmirshky interview

  After you gather doctor recommendations and research them thoroughly, make an appointment to meet the doctors and interview them. When you call, be sure to make it clear that this is an interview and not a checkup. I always offer to pay for the interview, but no one has ever charged me for his or her time. If someone does end up charging you, consider it money worth spending. Your well-being is w
orth the investment.

  I know you might be thinking, “Research, recommendations, interviews—E, this is way too much work! I’m having a hard enough time getting dinner on the table, and the kitchen sink hasn’t been fixed yet. There’s just no time to do all of these tasks.” But honestly, shmirshkies, this isn’t as daunting as it sounds, especially considering all the time we spend on slightly less important matters.

  Before I make a major change in the color or style of my hair, I usually make an appointment for a consultation. Yet before going through PM&M, I’d never had a consultation with a doctor. How ridiculous was that? My shmirshky is at least as important as my hair! It was time for a new process. It was time to think inside the box and put a high priority on my shmirshky needs. When you interview doctors, don’t hold back. Ask any and all questions you have. I cannot stress this enough. It’s your responsibility to be forthcoming with your doctor so he or she can be in the best position to help you.

  It is helpful to take an advocate with you to your interview and other important doctor visits (and if you take your advocate out for lunch afterward, the trip can even be fun!). Your advocate can be a loved one, family member, or friend. Often when we do not feel well, we are not functioning at our full capacity and may not hear clearly or speak up. Your advocate can be your extra set of ears and eyes and can help brainstorm with you as you evaluate your choices later.

  Before each interview, spend a few weeks using the Shmirshky Daily Symptoms Chart on page 168. It’s helpful to fill out your chart at the same time each day. I keep mine by my bed, as I find I have more time at night than in the morning when I’m rushing to get to work. Don’t worry, it only takes five minutes.