Tag: NHS

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To HRT or Not to HRT – Part One

On By samanthaIn HEALTHLeave a comment

The menopause, I am in my mid fifties and it is still a mystery to me. During my peri-menopause my periods got heavier and my migraines became much worse but, since then, I haven’t really had any symptoms. Or have I? I wake most nights feeling hotter than the surface of the sun and I sleep terribly, I’m usually awake between 3am and 4am. Then, in my research about preventing dementia I heard one Podcaster, Max Lugavere, whose mother died in her fifties from dementia, speak about how HRT can be an effective tool in warding off cognitive decline. I decided to undertake some rather belated research into HRT. Very few of my friends take it. Some of them have concerns about the increased risk of developing certain cancers and some are simply reluctant to take artificial hormones. Woman spend a third of their lives in menopause yet many of us really don’t know how to handle it or are even afraid of it. It seems to be viewed as the end of us being young(ish) and the first step on the path to decrepitude. Women past child bearing age are definitely less visible in society overall.

Some symptoms of menopause are well known, mood swings, insomnia, hot flushes and brain fog but I was blissfully unaware of some other potential issues such as the inner labia shrivelling once the body’s oestrogen supply is depleted. I have noticed that one or two of my friends have already begun to look slightly frail and post-menopause there is commonly a loss of muscle mass. I have definitely become a more anxious person during the past decade and this also seems to be the case for many women. The lack of sleep was my most concerning symptom, even more so than the migraines, because there is strong evidence that good quality sleep contributes to good brain health.

I listened to a few podcasts on the subject but all of the hosts seemed to have gone down the personalised private healthcare route, blood tests and hormones tailored just for them. My experience on the NHS has not been anything like that. Once I had decided to give HRT a try I had a five minute telephone consultation with a locum GP. To be fair, she seemed very knowledgeable on the subject and said she thought it was a good idea for me to take HRT as it can help prevent both osteoporosis and cognitive decline as long as the woman begins the treatment within six years of finishing her periods. She prescribed Estradiol patches, to be changed twice weekly and Utrogestan tablets to be taken before bedtime every night. She then called me a fortnight later to see how I was getting on. That was it, the extent of the medical advice. It seems to be a strictly “one size fits all” approach. I did ask how she knew which hormones I was deficient it if I didn’t have bloods but she insisted it wasn’t necessary.

As HRT requires a regular prescription you can purchase a pre-payment certificate which is currently £19.80 for twelve months. Beware though! The pharmacist at my local Boots put my migraine medication into the same bag without me realising and I received a £100 fine. In fact, on my last visit they did the same and tried to insist that I did not need to pay for my additional medications. This is incorrect.

I started HRT in January last year but my migraines seemed to become worse than ever and, after six months, I went back to the GP, for an in-person appointment. This time I insisted on a blood test. I saw a male GP who was at a standing desk. I completely understand why he chooses to work this way but it does mean that there is very little eye contact with the seated patient. This GP told me he didn’t really think that HRT offers any protection against dementia or osteoporosis . This completely contradicted what the previous doctor had told me and much of the research I had read. He said that my bone health was determined by the time I was fifty and there now wasn’t anything I could do to change it. He told me to take a break from HRT and see if my migraines improved. I stopped the treatment but it made no difference, my migraines continued to be unbearable until I sort further help , see my Migraine Misery posts. As I left the surgery I realised he hadn’t even glanced at my blood test results.

To be continued…

Thank you for reading

Samantha

Cover Photo by amjd rdwan on Unsplash

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Migraine Misery – Part Two

On By samanthaIn HEALTH1 Comment

In my recent post, Migraine Misery, I was complaining about my frequent and painful migraines. I finally got around to going back to my GP and asking for some help. On the day of the appointment I was on the fifth day of a migraine and my left eye was pulsating with pain and felt very nauseous. Although it is never good to be ill, I think my GP could tell simply from looking at me that this wasn’t just an ordinary headache. During the past year I have had migraine pain on more days than not and has really been getting me down. My migraine attacks became much more frequent during my peri-menopause but improved after my periods stopped but, once I started taking HRT, they were back with a vengeance. I stopped taking HRT months ago but there has been no improvement. I am keen to restart HRT for some of the long-term benefits that it offers.

I don’t have time to go and lay down in a darkened room and, even if I could, it wouldn’t make me feel any better. Sometimes I sleep with an ice-pack wrapped in a tea towel balanced precariously on my temple. Paracetamol won’t make any difference and I don’t like to take Co-Codamol unless nothing else has worked, it will usually relax the knotty, tight feeling in my temple but don’t take it if you are hoping to go to the toilet in he next week! There is a roll on menthol medication called 4-Head that may work with a mild headache but, if my migraine pain is at 100 it will maybe bring it down to 99.9.

I was hoping my GP would agree to send me for a MRI but, as the pain has not changed the way it presents, she said it is not necessary. I have been taking a drug called Sumitriptan for about fifteen years but lately it has not been very effective. My Doctor has prescribed Zolmitriptan instead. Triptans don’t prevent migraine but, if taken at the onset of an attack, they can be very effective in treating it. As a preventative measure my GP prescribed a beta-blocker called Propranolol. I have to take 40mg, twice a day, every day. There was some delay with the pharmacy having the medication in stock and I have to admit I was very reluctant to start taking the tablets, a daily medication feels like a significant step. I have friends who take Propranolol for anxiety and my dad takes beta-blockers since suffering a heart attack. The pharmacist telephoned me twice within the first fortnight of me starting the beta-blocker to check I wasn’t experiencing any unpleasant side effects such as “vivid dreams”. Well, three weeks in and I have never had such strange dreams in my life! I dreamed about my childhood bedroom and the detail was incredible right down to feel of the anaglypta wallpaper that I thought I had forgotten ever existed. It is amazing what our sub-conscious can dredge up.

A month into my new treatment plan and I have only had one migraine and that was on a day when I was dehydrated, always a trigger. The Zolmitriptan was extremely effective and I only needed one dose as opposed to three or dour doses of the Sumatriptan. Usually in this time period I would expect to suffer from as many as five migraine attacks so, so far, the results have been excellent. Other than the weird dreams, I haven’t had any side-effects other than feeling much better.

Thanks for reading,

Samantha


Cover Photo by Myriam Zilles on Unsplash

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Migraine Misery

On By samanthaIn HEALTH1 Comment

What does a migraine feel like? Well I suppose it is different for every sufferer. I am on the fourth day of a migraine that feels like somebody is power drilling into my left eyeball. It usually starts with a pulsating pain in my eye and radiates out to my temple, ear and neck. Sometimes my gums start throbbing as well and I feel nauseous. The pain usually lasts around four days. My prescription medication, Sumitriptan, is generally very effective but sometimes it just doesn’t work and this seems to be happening more often as of late. I rang my GP surgery a month ago for a “non-urgent” appointment and am finally booked to see a doctor next week.

I had my first migraine while having lunch with my mum in the restaurant in Debenhams department store, Romford in 1986. I was eating an egg mayonnaise sandwich and the pain just hit me out of nowhere. I can eat eggs, a couple a week, but more than that and I can expect to have a pounding head. Other triggers include processed cheese, grinding my teeth, stress, being dehydrated, being overtired, perfume and repetitive noise. Since my first attack I have seen my GP a few times but they never refer me on for a brain scan simply telling me it isn’t necessary as long as the pain doesn’t change its pattern. My GP surgery isn’t big on sending people for tests.

I sit at my computer for at least three days every week for my job, I am a Personal Assistant to a private hospital consultant, not a neurologist sadly. Like the rest of the world I also spend too much of every day pointlessly scrolling through my phone and then I will often watch an hour of something on Netflix before I go to bed. So much screen time! I have just had my eyes tested though and that doesn’t appear to be the cause.

I stopped taking HRT in the summer after I had a migraine for almost every day during July. I saw my GP who hardly even glanced in my direction and said, again, that I don’t need further investigation as the pain is the same as it has always been. He told me to come off HRT for a fortnight and see if it made a difference. Surely it would take more than a fortnight for the effects to be noticeable? Anyway I have not resumed taking it but that is another thing I want to discuss during my ten minute appointment next week. I initially started taking HRT after two five minute telephone consultations. I had read that it could be helpful in warding off dementia. There were no blood tests involved so I don’t understand how the GP knew which hormones I needed if they didn’t know which I was deficient in. I have now started waking up in the night feeling hotter than the surface of the sun so perhaps I need to restart.

During the five years proceeding my menopause I had weekly horrible migraines. My family got fed up with hearing about it. People think it is a “just a headache”. I was working in an office and I am sure the colleague I sat next to thought I was addicted to pain killers. I actually try to take as few painkillers as I can get away with but you try looking at a screen all day and making chirpy phone calls when it feels like you have a pick-axe embedded in your brain. It is different if you are at home and can go and lie in a quiet dark room but who has time to do that?

So, a rather moany post from me but I will report back after my visit to the GP. Wish me luck.

Thanks for reading,

Samantha


Cover Photo by Myriam Zilles on Unsplash

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It’s All A Lot Of Oysters But No Pearls

On By samanthaIn FAMILYLeave a comment

The title of this post is taken from the song A Long December by Counting Crows and seems to sum this week up perfectly although, now I have started thinking about it, I realise there have been some nice moments.

I have been ridiculously busy at work, feeling overwhelmed and it seems that my email inbox is like the fairy tale The Magic Porridge Pot, it just constantly refills. For very email I deal with three more seem to pop in. I have come to dread the accompanying chime. My shoulders have been hurting because I have been tensely hunched over my desk, working at the speed of light, for seven hours at a time. I am not very good at taking breaks but I need to get up and stretch every now and again before I completely seize up.

I had a day off on Tuesday and was looking forward a a little rest but my husband had booked a man in to clean the carpets, he was due to arrive at 8am. Groan. Obviously the rooms had to be cleared of clutter (thank goodness for my March decluttering efforts, see my post So Much Stuff! ) All the windows had to be left wide open all day even though it was freezing. I messaged my friend to have a moan and she invited me over for a cup of tea. How lovely to have a friend who knows you are chilly and proffers a heated gilet as soon as you arrive.

My dad called me later, in pain with toothache. Having had the most awful, ongoing dental infection a couple of years ago I have great empathy for anyone suffering like this. My parents can no longer get to the NHS dentist and have started using the lovely but very expensive private dentist in our village. Fortunately she was able to fit Dad in for the following day and I arranged to spend the afternoon sitting with Mum. I had some numbing gel that helped while Dad waited to be seen. Poor Dad, he really looks after his teeth, flossing and using interdental brushes but has been beset with problems for years. The dentist extracted the tooth, the second in six months. It was at the back of his mouth so he doesn’t have a visible gap. Mum didn’t really want me at their house and kept telling me to go home which can be a little hurtful but I just have to remind myself that she doesn’t mean it. Or perhaps she does, I hope not.

I then received a letter from the NHS telling me I was being fined for not paying for my migraine mediation months and months ago. I have paid for my prescriptions my entire adult life but the pharmacist mistakenly put my migraine meds in with my HRT which I had pre-paid for. How I was supposed to know this is a mystery. My husband had collected the sealed paper bag and I didn’t open it for weeks. I tried explaining this to the NHS appeals team but it was like speaking to a brick wall and I paid the fine which was around £50.

My daughter came home from university for a week yesterday. It was lovely to see her although as soon as she was through the door she said her laptop isn’t working well. I am hoping that a replacement battery will do the trick. We have been spending the evenings watching a documentary on Netflix called HellCamp: Teen Nightmare. Parents spent $16,000 in 1989 to send their wayward teens off to hike in the Utah desert for months at a time or to be stuck aboard a boat for a year. Some children were used as slave labour . The most famous participant in one of these programmes was Paris Hilton. Thousands of American children still attend these camps despite the recent bad publicity. It is nice to snuggle up with my daughter and watch something together, usually while eating a giant bag of Chocolate Buttons.

So not the best week but, looking back, nothing majorly bad has happened. There are so many people in the world suffering terribly at the moment and my trivial problems are inconsequential in comparison. I have just been feeling tired, cold, headachy and a little frazzled. I have probably also been watching the news too much. The spring will soon be here and it will be nice to feel the sun for a change.

Thank you for reading

Samantha

Cover Photo by Dagmara Dombrovska on Unsplash