Hot spots

.

My rising magma is of the hormonal kind and not something readers might be interested in.  ACTUALLY … given the number of middle aged women in the world … given the number of them you will encounter in your lifetime who are experiencing the disruption of hot flashes … it really is a discussion relevant to all.

I just want to sleep

I can put up with the regular changes of temperature during the day.  It’s not much different to sitting in a room with a heating or cooling system that has a dodgy thermostat.  Like the one where I work.

I cannot put up with the disrupted sleep.  Waking up every hour is not healthy.

Both the short and long term impacts are to be actively avoided.  And the impacts just compound, night after night.  With each decline, new coping mechanisms emerge.  But for how long?

Conventional wisdom

Conventional wisdom, now often referred to as the internet, was of little help.

To summarise:

• No one is sure what causes hot flushes, just that they occur at the same time as our hormones change.
• Hormonal replacement therapy is no longer considered fashionable.
• Some women are more prone to hot flushes than others.
• Suggestions of relaxation, exercise, diet and herbal supplements are offered up for eager consumption.
• Herbal supplements can have a negative impact on unhappy livers.

My GP’s offering was less insightful than that which I’d already read.

Left to my own devices, I resorted to an old-fashioned problem solving method.  Observation.

What I observed

Like a volcanologist tiptoeing up the side of a rumbling mountain … actually, unlike a volcanologist, I’ve been tiptoeing up the side of a rumbling mountain.  They know better.

It began with a conversation with someone who’d been there.  She had noted that night-time hot spots occurred after she woke up feeling cold.  That reminded me of one internet pronouncement that a hot flush may follow an activity that itself has followed a period of inactivity, like reaching for a blanket during the night.

From there, I noted a personal habit of holding my breath when I reached for the blanket … or reached for anything for that matter.  I then started noting how often I held my breath and how often a hot spot immediately followed.

Could holding one’s breath be a trigger?  Could it be that simple?  Surely that would have been on the top of the internet search results if it was true!

So, to test the hypothesis, I just sat there and held my breath.  And the magma rose.

It’s complicated

Of course, it’s not that simple.  I’ve been holding my breath for far longer than these past few months.  The is no argument from me that hormonal changes are a factor.

My next question was designed to build connections.  Is my held breath a trigger for something that then triggers a hot flush?

Drawing on past experience, I drew two words in large letters on the butcher’s paper (and then breathed my way through another magma rush).

Oxygenation – This could explain why exercise is recommended.

Shallow breathing and periodically holding one’s breath is limiting the amount of oxygen in the blood that is then available to all our bits and pieces.  Or to put it another way:

“The transition from rest to exercise requires quite remarkable adjustments in the cardiovascular system to meet the needs of the heart, respiratory muscles, and active skeletal muscles and to dissipate heat via cutaneous vasodilation.”  http://www.ncbi.nlm.nih.gov/books/NBK57139/

Increasing tiredness equals decreasing motivation to exercise.  Less exercise leads to insufficient oxygenation and a reduction in the body’s ability to dissipate heat.  Add to that my latest blood iron readings, which were way too low!

Fight or Flight – This could explain why de-stressing is recommended.

The poor breath control during physical activity was one obvious precursor to my hot spots, but it doesn’t explain why a casual chat with a semi-stranger at work, or why a puzzled expression on my face when staring at my computer screen, or why just sitting quietly and thinking about a problem all trigger a hot spot.

Turns out, poor breath control is also at the heart of these events, but I haven’t asked my heart or muscles to do anything extra.  Instead, I suspect that I have triggered my fight or flight mechanism.  It involves a number of hormones, including estrogen and cortisol.  If the estrogen supply is lower than usual, does this mean the cortisol has permission to run amok?

Common misconceptions

The common misconception that is bugging me is “loss of quality of life”.  Most people “get” the idea that fluctuating temperature is going to be an inconvenient disruption with varying degrees of discomfort.

I wish it was just that.

I’m standing in front of a filing cabinet at work, about to start a task I actually enjoy.  I utter an exclamation of delight and the next thing I know the temperature is rising, again.

I can’t even enjoy something!

The safest activity, though still not perfect, is sitting quietly in front of the tele watching unemotional documentaries.  It’s the easiest place to practice a bit of mindfulness, control my breathing, and keep all thoughts at bay, both the awkward and the amazed.

I call it “Dulling Down”.

I try a different GP

So I try a different GP, one in a dedicated women’s centre, one the receptionist tells me specialises in menopause.  I’m now armed with information about my triggers and looking for advice on what I can do.

But I’ve had two appointments so far, a chest xray, blood tests and an ecg.  Still nothing of practical help, nothing more than I’ve already read on the internet.  She schedules our next appointment.  It is a month away.  She is expecting me to put up with this for another month and even then there is no guarantee she’ll prescribe anything that will help.

Out of the blue

Then, suddenly, out of the blue, I sleep half the night without waking.  My mind clammers for information.  What did I do yesterday that was different?  I was more active.  There was a lot of walking and standing.  I had an iron tablet with breakfast.  I farted an extremely smelly fart which means the extra yaulkt has finally built up more gut bacteria than my body can cope with, hopefully suppressing some of the negative effects of the cortisol????????

How many question marks can one put on the end of a sentence?  In this case, in this state of desperation, not enough!

Next step

I will have an iron tablet with breakfast, go for a couple of long walks during the day and then down three tubs of probiotic drink before I drift off to sleep.  All in hope.

Update

Check out my post, Oh precious sleep welcome, for an update on how it’s going.

.