Health

HRT to treat PMDD week 19

November 27, 2022 — Leave a comment

Can’t believe it’s been 9 weeks since I last wrote an update on my HRT journey. A journey is exactly one of the words I’d use to describe it. There’s so much in the media at the moment about the use of hormone replacement therapy, and often strong opinions both for and against. I’d say for me, I’m still pretty on the fence.

So what are the three words I’d use to describe this most recent cycle? Improved, unusual, and you guessed it (a) journey.

Improved. Because, for the first time since commencing treatment I felt a really significant improvement in psychiatric PMDD symptoms last month. The level of anxiety was what I consider bearable (no anxiety is nice, but when you’ve felt close to the edge every month for decades, bearable is considered good!)

Unusual. This one is a weird one. I can’t work out why my symptoms were reduced. I’ve been using ovulation strips when I think I’m ovulating to confirm that I’m still cycling, and unfortunately- I am. So it’s not as if there was some kind of ovarian wipe out that can be thanked for the minimal mental turmoil. But we celebrate small wins here. And it’s nice to report feeling less tormented, for once.

The Journey is ongoing. In fact, I’m certain it always will be. Whether that be post op – or continuing with my reproductive system ‘in tact.’ I know this, because trauma and our experiences of it never really leave, so even in the absence of horrific PMDD my mind is still naturally searching for worse case scenarios. It can pluck them so easily from seemingly thin air!

Observations

I feel I need less oestrogen around ovulation and more straight after it. A steady dose of high supplementation is not always the missing jigsaw piece. I am not medical in any way, but I know my body, probably better than I know anything. If I have too much on the lead up to ovulation, I become anxious in follicular. This is less than ideal because this should be my ‘good’ week. So I am going to talk to my gynaecologist about tweaking dose and admission around this time, and see if it results in a positive change.

I’ve started planning my life around PMDD again. I used to do this around my period specifically, but now I focus solely on my moods and when they’re likely to turn. It’s not ideal, but it is necessary to get the best out of my days.

I’m about to ovulate again any day now and my usual body aches, shingles pain and mouth ulcers are creeping back in, as they do every month around this time. So it’ll be after next week that I’ll tell if I had a one off better cycle last month, or if HRT can indeed finally be thanked for the decrease in negative mood fluctuations. It’s a rollercoaster that’s for sure, but anything, any scrap of positivity is better than PMDD itself. So like with most minor improvements in my life, I cling to them with fervour and hope for the best.

Because in the end, despite science and medical intervention, hope is what keeps me going. ❤️

It’s a small world. A short story.

November 17, 2022 — 1 Comment

Selin Andrews woke up feeling flat. It wasn’t the first time this week, or even this month she’d felt drained of all her energy. Her mouth felt like sandpaper and her head as though it was filled with cotton wool. As she brushed the length of her long auburn hair in the mirror of her childhood bedroom, she stared at the dark circles that had become a permanent fixture around her hazel eyes, wondering if she could call in sick at work again, preferably without her mum noticing. Unlikely, considering her mum was a lady of leisure these days. Michelle Andrews spent an age dawdling around the house in the mornings, getting ready for lunches at the Ivy or another equally fancy restaurant, with one of her equally fancy friends. It wasn’t that Selin begrudged her mum this social acclaim, Michelle was a lovely mum whom was making the most of every second of her long awaited retirement, and Selin was happy for her, but she was also jealous. It pained her that her own life once so full of vivacity and social engagements, now revolved around whether or not she could summon the energy and the mental courage needed to climb out of bed and inhabit the shower of a morning.

You need to help yourself, Michelle would say, with kindness, though barely managing to disguise her evident frustration. What Michelle didn’t understand, is that Selin was trying to help herself, and she herself was also extremely frustrated. The days she managed to turn up to work despite being wracked with pain was such an achievement, she really felt as though she deserved a medal. Unfortunately nobody was giving out medals for turning up to work. Even when that turning up would cost Selin a whole weekend in bed trying to recoup some of the energy she’d lost doing so. She knew she’d been off sick lots. She knew her colleagues questioned the authenticity of her illness. She knew this, because she too had once been a colleague who rolled her eyes when the serial “sick note” called in yet again. That was until life had struck her with a debilitating illness that nobody could see. Sometimes as she sat here in her childhood bedroom staring at the garish pink wallpaper her mum hadn’t bothered to replace, she wished she’d lost her leg in a car crash. She knew these thoughts were irrational, insane even, but Selin felt with such an injury a modicum of sympathy might have been thrown her way. These days all she got was noncommittal murmurs and the odd poorly concealed eye roll.

Selin grabbed her phone from its charging port on her bedside table. As she tapped it the screen flashed up with a photograph of the family dog. Drew was an eight year old Red Setter that had the greying eyebrows of an old man, he was also her best friend. The knowledge that at twenty-five years of age she had a best friend of the non human variety depressed her greatly. Her phone told her it was six fifty am and that, as expected, she had no new messages. She tapped into Instagram where her life lit up again. People all over the country and some even in other parts of the world, passed by her profile to double tap on a picture or comment on one of the many inspirational quotes she liked to share. She had friends and family following her instalife too, but either rarely bothered to take the half a second it took to double tap her latest upload, and even fewer left comments or slid into her DM’s. But when Selin’s body forbid her from being able to leave the house, it was this virtual world that was helping her stay connected. When her friends had stopped checking in and her world had become small, this online space had opened up to fill a void. It allowed her to connect with people who understood her situation. People whom were going through similar themselves.

It had been four years since Selin had been diagnosed with Fibromyalgia and Chronic Fatigue Syndrome, though the reality was she’d been living with it and many comorbid conditions, for much longer. Her life had once been vibrant and full. Days and nights out with friends scribbled on a calendar which had hung loosely to the kitchen wall in her flat. Her flat. The one she had shared with her ex, James. James had been a good boyfriend for the most part of their relationship, he’d stayed in a lot of nights with her when she wasn’t physically able to drag herself out to socialise. He’d been with her that day in rheumatology when she’d been diagnosed. He’d even seemed positive at first, with a real desire to help her manage this complex condition. Then when she’d been off sick for weeks at a time and he came home to her unable to move from the sofa to their bedroom without his help, he’d started looking at her differently. It had happened gradually, the transition, his blue eyes that had once belied a lust and deep love had started to look at her with pity. Instead of staying in with her on the weekends or planning around her illness, he’d began going out more often with his friends. Coming home later and later, until one night he didn’t come home at all. Selin had been out of her mind. Already prone to anxiety, she’d called all of his friends to find out where he was and when they weren’t forthcoming she’d phoned his family, and the local hospitals.

As she sat now scrolling her newsfeed, double tapping on posts she’d missed from people she followed, she decided that today would be one of those days she fought her body and took it to work. Or at least, she’d give it her best shot. ***

Lacey Rowe had been following Selin’s ChronicallyBored instagram page for some time. She liked seeing the quotes Selin created herself and shared with her audience. Lacey also had fibromyalgia and it had become so bad over the past two years she’d had no choice but to give up her job at a publishing house. Lacey now stayed home day in day out, doing her best to manage her health. She was relentless with routine and tried hard to go to bed at roughly the same time every night, eat consistently healthy foods and had given up her beloved wine in search of cures. A belief that cutting out vices would ease her pain. Lacey no longer worked, but she had responsibilities Selin didn’t have. Lacey had a son. His name was Rafe and he was just about to turn three. Rafe was a well behaved three year old. His cherub face was always smiling and his speech was great for his age, he also never, ever, forgot his manners. In some ways Lacey took all the credit for his upbringing, she knew she’d done a great job and he was teacher’s pet at his preschool too. But she also felt immense guilt. Every time she looked into her son’s chocolate brown eyes and sniffed the sent of his chestnut hair, she felt a stab so acute she wondered if a person could die from such feeling. Lacey’s guilt stemmed from not being able to do all the fun things Rafe’s friends’ parents did. Like host parties in their gardens and offer to help out for stay and play in his preschool class. For starters, living on benefits meant they had very little money left over after necessities were paid for, and secondly, Lacey simply didn’t have the energy or confidence to offer to volunteer her time. She knew the other mums at preschool thought she was odd, possibly even rude. She was neither of those things, but she was unwell. Making small talk was hard for her as brainfog rained over her thoughts and left her forgetting her words. She would constantly stutter and trip over them whenever she attempted conversation with a stranger. That’s why she loved following account’s like Selin’s. They made her feel seen. She knew Selin didn’t have children, but in age there was not much between them and she was pleased to learn they even lived reasonably close to each other. Selin was always tagging Bath as the location in which her photos were taken and Lacey lived about twenty minutes away by train, in a suburb just outside of Bristol.

***

Selin’s workplace was situated in central Bath. What was once a Georgian townhouse was now several small office spaces where she worked selling advertising for a local newspaper. The building itself was ornate, complete with sash windows and a boardroom- which had likely once been the lounge of a wealthy bank manager- overlooked the heritage city. Her office was quiet. The desk she manned was one of four, the others inhabited by Janet, a vibrant lady of indeterminable age, Sasha, also twenty-five and already married to a successful entrepreneur and Juliet, Selin’s very stern, and very straight, boss. Selin’s role was mainly administrative, fairly low grade and uncomplicated work for most people. Though Selin wasn’t most people. The moment she’d entered the building earlier that morning, she’d known it had been a mistake. The air was stuffy and emitting a damp smell which played havoc with her senses. The monitor she was working on too bright and the chair she sat on no longer adjusted to support her back. The pain had accosted her body just ten minutes after the start of her shift. As she forced her eyes to focus she felt her phone vibrate in her pocket. Realising it was now almost lunchtime, she decided to wait until then to read the notification, which she doubted was anything other than one of her many shopping apps alerting her to their latest sale. When she finally did walk out onto the cobbled street and pull her phone from her bag she saw instead that is was a direct message from Lacey. Selin had interacted with Lacey tons of times since the launch of her instagram profile and they’d had such a good rapport she felt as though she really knew her, despite the two of them having never met in person. Lacey’s message was about to change that, it read: Time to stop talking about it and plan in a date to meet up. Rafe is at his dad’s this weekend why don’t you come here and we can drink tea and lounge about on the sofa?

Her anxiety addled brain told Selin no way. She couldn’t possibly travel to Bristol on her own. She would have a panic attack or get stuck trying to get off the train. She’d be in so much pain when she arrived that she’d surely need a lie down immediately, and what fun would she be to Lacey then? Lacey had anticipated this would be her reaction and before Selin had even begun typing a reply her phone chimed with a second message: I know you’ll be tired when you get here so I’ll collect you from the station and drop you back whenever you feel like you’ve had enough. No pressure. X

She needed a friend, more than she had ever needed anything in her life. Somebody to complain about the day with and make inappropriate jokes about life with chronic illness. The kind of jokes that healthy people didn’t understand or find funny. She decided that instant that she would go. She still didn’t know if she’d manage the train though and planned to ask her mum to give her a lift instead. Hurriedly, whilst trying to stuff half a tuna baguette into her mouth at the same time, she sent a message back accepting Lacey’s invitation.

***

When Michelle pulled up outside Lacey’s new build with its overgrown hedge, she noticed the children’s toys stacked neatly to the side of the blue front door. It was weird to her that Selin would have a friend with a child. She was still Michelle’s baby, and her life had been so halted since she became ill that Michelle often wondered if Selin would ever make her a grandmother. Nevertheless she was glad her daughter was making friends, and hoped that the shared experiences would mean Lacey wouldn’t drop her daughter like a hot cake when the going got tough. Because it did, get tough and she’d seen the devastation Selin felt when friendships had inevitably failed. She’d felt the grief of her daughter’s health just as profoundly as Selin herself had. Smiling, she waved her daughter goodbye and drove the thirty minute journey back to Bath with a good feeling deep in her solar plexus.

When Lacey opened the door Selin knew instantly that she’d made the right choice. The petite woman with her dark hair and elfin features drew Selin into a deep hug and told her the kettle was on. Lacey’s house smelt of cinnamon and though a little untidy in places, it wore the coziness of a much older, and well lived in space. Sinking into the soft leather of Lacey’s sofa whilst waiting for the tea to brew the pair struck up a diatribe of conversation that was so easy it felt as though they’d been friends ten years, not ten minutes.

The two women spent the afternoon laughing. They drank copious amounts of tea that had Selin running to Lacey’s downstairs loo every half hour, sitting on the pan with the door ajar so she could continue conversation. They had so much in common it felt bizarre. Lacey opened up about the breakdown of her relationship with Rafe’s father, telling Selin how he’d left her when she was a few months postpartum and suffering severe postnatal depression. Selin told Lacey how James had become more like a carer than a lover. They each took comfort in the other’s life experience and neither felt they were being pitied. In fact their respective health, though relevant to the conversation wasn’t the focal point. They both loved eighties music and neon, fancied the new bloke in Eastenders though neither could remember his name.

When it was time for Selin to leave, Lacey hugged her new friend tightly. A solidarity had formed between the pair and when they agreed to meet again in a fortnight and venture out for lunch, each knew, without discomfort or simmering insecurity, that they’d be there. Being sick had made each woman’s world undoubtedly smaller, but together they were about to take future steps towards growing them. Each were as certain of the friendship’s likelihood for longevity as they were that daffodils would bloom the following spring.

Confessions Of A Chronically Ill Mum #21

November 6, 2022 — Leave a comment

Yesterday was a bit of a pity party – sometimes we’re allowed to have those. As long as you don’t outstay your welcome at the party, you know, make sure you leave before the sun comes up. It’s totally justified to indulge in self pity once in a while, when life feels too much and you’re overwhelmed, and everything’s going wrong or you’re unwell. The idea of being positive all the time really can feel quite toxic. I’ve been feeling lonely, as though my circle has shrunk to such a minutiae and I’m struggling to find anyone to reach out to that I haven’t bored to tears with my problems a million times already.

I love a bandwagon – Spirit Costume

In the space between my last update and now, so much has happened. Too much. I will never have the short hand speed or memory to recite it all. Today though, I ‘dusted myself off’ it’s been a week in the making, because for the last 5 days I have slobbed about half naked, nursing a sick baby and struggling to get on top of my own ailments.

I guess the most notable thing to happen and served to also be most terrifying, is my son’s recent contraction of Hand Foot and Mouth Disease. A ‘mild’ childhood illness that’s extremely contagious and turned out not to be very mild at all. Don’t get me wrong, he’s recovering well, but the symptoms were savage. He had a high fever for days, constant vomiting and was writhing in agony from the blistering rash that covered most of his body not just his hands, feet and mouth. It was awful to watch. It took us two days to be seen by a doctor and over a week for his symptoms to dissipate.

Secondly, and more life changing…. I handed in my notice at work. For years now I have been trying to hold down a job that requires me to be present during the core hours of 9-5. As a sick person who is also a parent, I have found this almost impossible. Since having Kaiser and the landslide both my mental and physical health took, it became really impossible. Because, not only am I shit out of luck with childcare, I’m always ill. Meaning, somedays I’m not able to function prior to 11am and other days it’s 8pm before my brain has travelled through and out the other side of its’ fog.

It wasn’t a decision I made lightly. I mean who in their right mind would quit their job during an economic crisis, right? But I really did feel I had no choice in the end. Despite my employer really trying to support me, my own sickness absence, on top of dependants leave to compensate nursery closures and childhood illnesses, remained high. Since starting HRT my memory has been awful, my mental health is fragile at best, and physically I still cannot sit or stand for any duration without being in real pain. I didn’t want to leave my job, but something had to give and I’m not well. I haven’t been well for years. I’ve pushed through until now, for the bare minimum and it has had a detrimental effect on my whole life.

Silly really, but I sat with my hand hovering over the keyboard for ages before taking the plunge to post this. There are so many parts of me that feel as though I’ve failed. As a wife, and as a mother. Some moments I think the guilt will swallow me whole. I’ve agonised over what people will think and indeed whether or not I’ll be able to feed my children without a stable income.

That said, I made this decision with the help of my family because we believe it is the right one for us. I’ve realised it’s not that I can’t work at all, it’s that I need to be able to work around my health and my parental responsibilities. Unfortunately life doesn’t offer many opportunities for disabled parents to be able to do that. However, I’ve recently put my heart and soul into the charity work I’ve been doing for PMDD and I plan to continue to do this, while also trying, once again, to make my writing work for me. So if you’re after some copy, a CV, or are interested in having me write an article for you, please get in touch!

5 ‘Therapies’ that don’t involve a therapist.

October 23, 2022 — 2 Comments

My world has been spinning out of control again recently. I’ve felt once again overwhelmed and incapable of coping with so much responsibility whilst being so unwell. I’ve not felt like ‘me’ and some days, I’ve not been able to articulate what being ‘me’ feels like. The worst part is -or one of the worst part(s)- as I come out the other side now, is, I know all of these feelings are down to PMDD. Yes I still have overwhelming responsibilities and health issues, with seemingly endless insecurities, in spite of PMDD, but none of them feel as overwhelming when I’m not premenstrual. Such a scary illness… I can’t even… so I won’t…. Instead I’m going to list 5 things that have helped me cope and survive the past week during the latest luteal maelstrom.

I was lucky enough to spend the weekend in Weymouth with my mum and Ciara and truthfully, I had never needed the time away more. The weekend arrived when my panic and anxiety was highest in my cycle. Being around my mum is helpful because she’s very understanding. Though it’s still difficult sometimes to be around people when you’re not at your best. Below are some of the things that helped me through those days and I know they benefitted not only me, but Ciara and mum too.

1. Watching the sunrise.

There’s something so therapeutic about watching the sun rise. There’s a sacredness to being awake before the world officially starts it’s day. Of course there are always a few people milling around, but the first morning light is like a balm for my mind. Even better that this time I got to watch it by the sea. To view the sun’s reflection and listen to the waves lap at the same time is magical. I’ve always felt quite lonely and not very safe at the thought of going outside at the literal crack of dawn, but winter months bring a later sunrise and in the last fortnight I’ve made the effort to get up and out twice to watch it, and can report it was so worth it. There’s a placidity to it that calms my jangling nerves and puts me in a better place to start the day.

2. ‘Fancy’ dress-up

Let’s face it, we’d all like to pretend to be someone else once in a while, right? The sheer effort somedays to put a face of makeup on and make it outside is too much to bear thinking about, but somehow going out of the norm is strangely comforting. I loved being this witchy woman and picking pumpkins with my mini. I wasn’t even bothered at all the weird looks I got -and there were a few- if anything though, I got a confidence boost from them. Sounds weird I know, but with Halloween fast approaching there’s literally no better time to have a bash at being someone else.

3. Creative craft

It’s not ironic that I write my worst days. Ask any creative and they’ll tell you some of their best work was created during times of extreme stress or melancholy. Even without delving into the history of creatives and mental illness, for many of us craft and creativity can be a therapeutic outlet. In fact it’s even seen used in practice such as mindfulness and some forms of CBT. I often try to get creative with the kids when I or they are feeling stressed. It’s a great way to connect without any pressure. It’s something we both, particularly Ciara and I, find really relaxing. This (pictured) creative practise was simply ‘free’ drawing on pumpkins and it was soothing for us both, a great way to wind down from the day’s stressors or after lots of high intensity activity. It’s also a cute Halloween craft and a great idea for rainy days.

4. Creative Writing

As above. The creative process is a calming and therapeutic one. For me, words will always be my go-to outlet. Writing all my thoughts really does help me to process them. This notebook created by my friend and literary idol Emylia Hall, founder of the creative writing course Mothership Writers is full of motherhood writing prompts and gorgeous illustrations. It was the perfect accompaniment to a really rubbish week. I can honestly say I felt better during and after using it. It’s definitely going to be a permanent fixture in my self soothe kit.

5. Nature: Preferably involving wildlife

You don’t have to be an animal lover to appreciate the beauty of wildlife. Some of my favourite de-stress activities include animals in their natural habitat. When I first suffered with lingering PND after Ciara was born back in 2016, a common favourite was feeding the ducks and I’ve resorted back to doing this whenever I feel low. Earning the trust of wildlife requires being present and patient and that’s why it’s such a great grounding activity for when you feel as though you’re losing your mind. This little squirrel pictured, was a little too tame to be honest and made himself comfy on my thigh in wait for Ciara to snap open a monkey nut. It left me with a smile though, and there’s a lot to be said for simple pleasures.

This blog is not intended to substitute medical advice or the advice of a trained professional. If you need to speak to someone about your mental health, please make sure you do so. Be that your therapist, GP or an organisation such as Samaritans. And remember that if you’re concerned about your ability to keep yourself safe please call 999 or go to your nearest A&E.

In the interim though, these few simple, accessible and affordable techniques may help you focus on the present moment. Particularly for those rollercoaster mental health days that are often up and down. To prevent spiralling out of control all together, maybe one or two of these activities can help you process your thoughts a little more clearly. I’m by no means an expert, apart from in the field of my own lived experience, but everyday I am seeking small but manageable ways to be more mindful and regain a modicum of control over the often obsessive thoughts that plague me during both PMDD and times of high stress. We could all do with taking more breaks, and so I hope this blog will be helpful in encouraging you to do just that.

Confessions Of A Chronically ill Mum #20

October 15, 2022 — Leave a comment

It’s 2am on Saturday morning, or Friday night- whatever….and I’m wide awake. I have been to sleep but I’m having awful trouble staying there. I had a significant psychological wobble earlier this evening.
After the hype around my debut newspaper article earlier in the week, followed by genuine relief at another good day in the bag for my son (who is really struggling with separation anxiety currently) at
the childminders. This wobble knocked me for six. It shouldn’t have really, because I’m at the end of my cycle, and I know what that means….

For those of you that know about my health already, I won’t need to say much – other than PMDD got it’s claws stuck into my psyche.

I’m a paranoid, angry (fuming actually – but don’t ask me why) tearful, mess of a woman, whom also told the car insurance telephone handler earlier in the day to get a new job because he had the intelligence of a
gnat. Who even am I?

I have felt physically terrified for no
reason. I wanted to lash out at other parents for breathing next to me at the harvest festival. The sound of my kids’ talking and playing made my skin hurt. Don’t even get me started on what Kaiser’s screaming is doing to my blood pressure. I have a mouth full of ulcers, limbs made of lead, period pain that feels like labour, and can’t stop itching – oh and eating!!! And all of that is ‘just’ menstrual – not to mention sitting or standing for more than 5 minutes at a time leaves me in agony, getting in and out of the car and lifting my son makes me want to cry. To add insult to injury, everything I do to relax fails, every book I attempt to read feels like
the words are sliding off the pages and flying the fuck away from me. I just can’t process life at all!

“Stop the waltzers! I prefer the certainty of a prize that comes with hook a duck”

There are so many points I want to make with this blog post. The main one is, these things, this trauma and constant carousel of feelings that come with chronic illness, don’t ever really go away. No matter how long you’ve lived with something, no matter how great the good days are, there’s a lingering trepidation of when the lights might go out again and how long it will take until, or even whether or not they’ll eventually come back on. Of course the evidence suggests they will [the lights] come back on, but it’s hard to believe when you’re run down and in pain.

It’s Saturday lunchtime now and I’m waiting patiently to be seen in rheumatology again. The combination of the constant diarising of appointments, childcare and HRT, is making me forgetful. I’m struggling to keep up with my physical therapy exercises, which I know is only going to exacerbate my pain in the long run, but that’s really the point I’m trying to make in response to all the ableist propaganda circulating at the moment – having a chronic illness is a full time job and when all of your time isn’t being taken up trying to feel better, you’re planning damage limitation for the next time you might feel shit. All of this of course on top of parenting, being a wife, friend, working part time in a regular job and so on. It’s not easy, it’s definitely not fun.

It’s Monday and Kaiser has had another awful day at the childminder’s house resulting in me in tears the same time as he was, with less than a mile in distance between. Shaun had to leave work to collect him in the end. It’s unfortunate that this coincides with the week I’d usually be on my period – which means the rage and anxiety and general feelings of overwhelm are taking hold. I’m again anticipating what the fuck I’m going to do if I have to seek alternative care for a baby that is already so anxious in the face of change. Or god forbid I have to leave my job to care for him full time when I’m barely surviving caring for myself.

Bedtime now and yet nobody sleeps. Shaun tiptoes around the house on his size tens and Ciara is up and down like a yo-yo with various complaints of insomnia. Kaiser will be awake in a minute, desperate for a cuddle.

I love being a mum but I struggle with it so much. Every month I wonder how I’ll survive and what the future looks like if and when I eventually lose my shit all together. Somehow we make it though, we adapt and make allowances and exceptions.

People say I don’t know how you do it and my reply is always I don’t have a choice. But that’s not the only suitable response: another appropriate one would be I don’t do it, we do it. Together! Because without them, there’d be no me. Forever grateful to be lucky enough to have created this wonderful family even with all of our flaws, challenges and trials combined.

HRT update – Week 10

October 2, 2022 — 1 Comment

Hello and apologies. Once again I’m a little late with the update. The truth is, the last four weeks have been all over the place, and at times not at all kind to me physically, hormonally, emotionally or professionally.

If I had to describe this most recent cycle of HRT in three words it would be: Exhausting, variable, and unstable.

Exhausting because despite being in the third month of this trial, my sleep is not really anymore settled and fatigue has been really crippling me. I’m so tired during the day and we’re not talking just a few yawns here or there, it’s a real physical inability to keep my eyes open. I’m still struggling to remember what I walked into a room for and small things that may have seemed insignificant in isolation are problematic with reoccurrence: things like sending Ciara to school in her PE kit on the wrong day and similar. Combining this with parenting a one year old stunt man and six year old diva, is not cool. It’s also quite dangerous. Unsurprisingly of course there are sans day time naps, thus perpetuating the cycle of exhaustion.

Variable is the big one. I’ve felt physically unwell for weeks but have managed to keep a level of emotional equilibrium. I’ve lost my hair, I’ve lost hope and I’ve felt really unsettled. I’ve also had days where I’ve felt extremely hopeful, excited, energetic and healthy. So far there’s really no real tell to suggest HRT is working miracles or not, because the symptoms are still so variable and as mentioned I’ve actually felt quite a lot worse physically for the last few weeks. What’s unclear though, is whether this is related to the HRT at all, is it Fibro, is it from starting new statin medication? Or is it indeed the usual hormonal hell experienced during a cycle in which I am still ovulating?

Unstable. I mention this because the simple fact that this process is soooooo variable makes me feel a little unstable. I have hope, I really do, that this will improve.

The thing about hope is though, you always have to be holding onto it. If you drop it, it’s gone, ‘poof’ and all of the trial and error of the last three months is worthless.

divamum

Upsides:

I don’t want to be the person that puts you off giving this stage in the PMDD treatment pathway a go. I wouldn’t still be slogging it out if there wasn’t some evidence based merit to using combination HRT to treat PMDD. So I’ll let you into the upsides, the positives I’ve experienced since I’ve been on this latest hormonal rollercoaster.

Fewer migraine attacks. This is a huge one for me because for the last 2 years I’ve suffered migraine every week with attacks lasting a minimum of 36 hours and always rendering me completely disabled. Since commencing HRT I’m only experiencing attacks in the week prior to my usual period. (Usual because I’m constantly bleeding but migraine is only present when I would normally be premenstrual.) There’s a lot of controversy over the safety of using supplemental oestrogen with migraine. However it is suggested that transdermal oestrogen is the preferred way to supplement if you have migraine. Migraine is the most debilitating, painful and abhorrent condition that I live with, it’s also problematic for my mental health, so any reduction in severity, really is huge for me.

Less intrusive thoughts. I am still experiencing anxiety and it is still a symptom that can be severe and have a profound impact on my overall mental wellness. With that said though, HRT has seemed to help take the edge off of the extreme and terrifying thoughts I was experiencing prior to starting treatment. I guess in a nutshell I’m more rational. This could also be down to the year of therapy I’ve just completed, but if I’m being honest I did not feel this level headed upon completion and believe the oestrogen has (completely contradicting myself here) stabilised some of these symptoms.

Conclusion:

More time. I spoke to the amazing gynaecologist I saw back in August this week, I’ve emailed him several times and he has always replied the same day with advice. As I am still very early into this treatment method he believes to really understand if I am not gaining any benefit, we need more time. When he said this I was really fed up. Then I took stock and really considered it. I thought about what chemical menopause might look like for my family right now and discussed with my husband the idea that we go ahead now, or wait until after Christmas. I know I’m going to need chemical menopause and ultimately surgery in the next year. I know this is a given if I want to keep myself and my family safe and reclaim my life. Because I know, categorically, that I can’t do another year of living with PMDD. The question I have to ask myself is could I do another few months of living with this slightly shorter, slightly improved, less disabling, watered down version? And the answer was, probably.

So that’s the conclusion for now. I also discussed with the gynae my fear of feeling worse when initiating GnRH injections. He proposed the idea of trialling a nasal spray in the first instance instead. I felt even via transient email communication that he had heard my fears. Ultimately, I feel as though I still have some options.

To assist with the reoccurring bleeding, hot flushes, sweating, and the intense fatigue, we are going to introduce a third pump of Oestrogel. I’ll start taking this at night and continue with my two pumps in the morning whenever I feel ready. Again – not going to pretend I’m not concerned this could make me feel worse initially, but even having the option and wiggle room to tweak the dose, is a blessing in itself.

Once again I’m ending this rather complex post with hope in my heart. I’d like to thank everyone who has answered questions for me too, it helps, and especially my fellow #PMDDpeeps over at IAPMD I am lucky to have such knowledgeable women in my corner.

Confessions of a chronically ill mum #19

September 24, 2022 — Leave a comment

Hi. It’s been longer than my usual long while since I posted COACIM. In fact, I haven’t been writing anything much and definitely nothing so personal. I’ve had neither the inclination or the ability, and I’ve barely been keeping up with my medication not least my mothering responsibilities. It’s all felt like such a lot lately.

Not sure if I mentioned here before, but back in March I saw a consultant about my cholesterol. It was ridiculously high, putting me at serious risk for heart and cardiovascular diseases. I resisted starting medication because I’d not long commenced HRT. I’m already quite heavily medicated for my anxiety, fibromyalgia and migraine, and statins have a bit of a bad rep for side effects. Anyway, last month the consultant called me and said I had no good cholesterol in my body and without medication ‘it’s not a case of if you’ll have a heart attack or stroke it’s a case of when’ adding firmly at the end ‘you’re a ticking time bomb.’

This conversation took its toll on me mentally, as you might imagine it would. Especially because since the appointment in March I’d been working really hard on looking after my health and essentially this consultant was telling me it wasn’t good enough. I felt at this point as though I had little choice, so I ignored my reservations and started the statins.

Long story short, so far the side effects are indeed awful and I have been really unwell. The worst flare up in my fibromyalgia symptoms I’ve seen for some time. I have been wading through treacle each day, or at least that’s how it’s felt with the level of fatigue I’m suffering. Brain fog and my memory, which had worsened significantly since starting HRT anyway, is now shot to bits. I’ve always prided myself on having a good memory and taking in information but for the last two weeks I have barely remembered what day it is, and that’s not an exaggeration. I’ve led in bed on days I’m supposed to work and been confused at why my alarm is going off and Kaiser’s dressed for the childminder. I’ve not been able to write because I can’t remember what it is I’m trying to say. It sucks, and this post itself has taken me a week to finish.

As you may know fibromyalgia causes widespread pain and profound fatigue. Since starting statins this has worsened and I have severe muscle pain, while also feeling as though I have the flu, all the time. I’m napping during the day when Kaiser naps and having to throw water on my face to stay awake during a work meeting. I can’t lift my son because my body feels too weak.

Parenting is kicking my proverbial. Day and night, night and day. Even after having a break last weekend to sleep and recharge whilst the kids were with my mother in law – it doesn’t feel like enough. I need a break after 10 hours. Shaun and I are drifting with no real idea where the fuck we’re going because we’re too exhausted to hold a conversation. He is knackered from picking up all the slack and it’s pretty shit because I don’t know what my alternatives to these tablets are. The consultant made it sound as though their wasn’t one. Kaiser has started walking and yes…he’s a total babe, but he’s also hands down the most exhausting human I’ve ever come across. I find being his mum a privilege and sometimes, like now when I’m not feeling my best and being brutally honest… a chore.

I have a feeling Ciara might be going through some developmental changes, because her emotions are all over the place and it can be hard work trying to prize out of her what’s going on. She is a tiny perfectionist whom hates doing badly at anything and it’s become more pronounced this term. I don’t know why or how this has become such a big deal to her because we rarely ever tell her off and absolutely never for getting something wrong or making a mistake. It’s gut wrenching to see your child grapple with their emotions. She also has the hearing of an elephant and questions everything you say, remembers it, then recites it back to you… so there’s no hiding in this house and sometimes let’s be honest, mums want to hide (well I do anyway)

Finally, I wanted to add that I’ve been feeling quite sentimental and at times, extremely lonely. Your world can become horribly small when you’re unwell and people do drift. I’m not blaming those people because I know it’s nobodies fault – when someone (me) is constantly cancelling plans and letting people down, often last minute, you lose your place as first on the list as an invitee…. I just think Covid and everything else that’s going on in the world right now has highlighted to me how insular I’ve become. It’s a bit of a dichotomy for me to be honest, because part of me loves being in a familial bubble and not having to explain myself to people or show up for small talk, but the other part of me is in need of genuine social and human connection. What I do know is I don’t really have a lot to say about much other than my health and the kids, and I’d like that to change soon, adding a bit of me back into the bargain.

Overall, and in spite of what you’ve just read, I’m happy. I’m trying and sometimes even succeeding to not letting myself be sucked down into my usual negative cycle of mum guilt and self loathing. And I feel immense gratitude to be embarking on new journeys and to have had some really amazing and exciting opportunities come up for me recently. I will elaborate at some point but ultimately what I’m trying to say is, I don’t want this post to be all doom and gloom, because my life isn’t all bad in fact it’s mostly good but it’s still hard to live with poor health when parenting small and impressionable children.

I do also have a HRT update for you but for now I can’t even begin to concentrate enough to fill you in on that, too. It’ll come soon if I can manage it! 💙

Confessions Of A Chronically Ill Mum #18

August 29, 2022 — Leave a comment

It’s been a while since I’ve written an insert of COACIM. I’ve been busy, trying to keep PMDD under control alongside parenting a riot of a toddler, a somewhat sulky six year old…. Summer holidays and work. So I guess you could say I’ve been ‘doing life.’ For the most part doing life has been good, the summer has been busy and full of adventure. The downside being, I’m still not (and never will be) able to do everything I want to do because of my health, both physical and mental. The limitations it has on my overall well-being might have lessened somewhat but is still profound. However, I’m so grateful, now more than ever for all of the things I can do!!

Since starting HRT I’ve noticed an increase in energy and my ability to move more freely. My joint functionality and all over flare up time is less than it was before commencing hormone replacement. PMDD episodes are shorter too (though not necessarily less intense) I won’t go into too much detail about that now, because there’ll be a separate HRT update shortly. For now, there’s so much else I want to say.

Emotionally, I’m riding the waves while trying to savour every moment we get to enjoy as a family. 

My confession this week, is that I’ve realised, in recent months since adding in a few evening plans, just how much I miss dancing. I’ve had two occasions where I’ve been out and there’s been music. The first one was with Shaun, we went to Cardiff to watch The Libertines. They are one of our mutual music loves and it was a long anticipated gig. Thankfully the venue sorted us out with accessible seating and this was in an area with enough room to dance if you wanted to. Though I soon realised, I can’t. I can no longer move freely without pain. Even the ‘dancing’ I can manage, such as waving my arms in the air, causes me pain. While I may be able to walk a little further than I could before (and this is great) I still cannot remain standing for more than a few minutes, and sadly, I definitely can’t dance, at all really! When I realised this I became quite upset. Because let’s be real there’s nothing quite like being able to dance it out. (Fans of Greys anatomy will appreciate the reference) Like I said, I am trying to focus on what I can do as opposed to what I can’t, but it still irks and hurts and leaves an adverse feeling in the pit of my stomach.

The second music shindig I attended was Meatloaf inspired musical Bat Out Of Hell. The show was phenomenal, but again I couldn’t move much. As with standing, I find being seated for long periods really uncomfortable too. Driving is agony and I’m only really comfortable when I’m slowly walking or led down. This can put a real spanner in the social life of a music lover. Yesterday I spent hours nostalgically reminiscent of the bank holiday weekends I’d spend at all day music concerts and outdoor day festivals. Some of this nostalgia was not just mobility related though. I’ve been struggling with the kids in general over the last few days. As the end of my cycle closes in the misophonia creeps out and my tolerance levels reduce to almost zero. I’m snappy and so fatigued I can barely keep my eyes open. Meanwhile, both of my children are charging around like bulls in proverbial china shops, shouting at the top of their small-but-mighty lungs!

Parenting is hard. You don’t need a blog post to tell you that. What I will tell you is that it feels twice as hard when you’re operating on no sleep, struggling to move, and your brain is prisoner to the fluctuations of your own bodily hormones. I don’t want to muddy the waters because we really have had a lush summer. We’ve crammed in a lot and near crippled ourselves financially (and that was on a tight budget) but there are so many memories from this time we’ll keep. No matter how nice it’s been though, I know I’m not the only mum who can’t wait for routine and early nights to resume. 

Another confession is that I’ve been feeling uneasy about using my disabled badge and sunflower lanyard. When attending The Libertines gig I had access to the disabled toilets so that I didn’t need to queue in long wait times for the loo. This was necessary because as mentioned - standing for long periods causes me a lot of pain! Despite the necessity I still felt as though I was being judged. Groups of men kept trying to get into the disabled toilets after me and even said the dreaded words ‘There’s nothing wrong with you’ to my face. It’s a confrontation that I just don’t want to be having whilst I’m more than capable of telling them to fuck off and stating my rights as a disabled person, I don’t want to. I instead want to be able to enjoy my night out with ease and not fear the need to defend myself against other people’s ignorance.

Please remember that not all disabilities are visible. Not everyone whom is disabled will appear to be, and with risk of sounding really glum here, it could be you one day. None of us are immune to ill health and injury. You don’t even have to be kind if it really pains you to do so, you just have to mind your own business.

Ask Me About PMDD

August 26, 2022 — 1 Comment

Earlier this week I shared the below image to my Instagram stories and gave you the opportunity to ask me any questions you might have about PMDD.

Image used with permission from IAPMD

Having suffered with this illness for more than 20 years I feel I am equipped to answer questions relating to the condition and as a result of my own experience. However, it’s important to note I am not a medical professional and all answers are my own words, with no association to any organisations that are linked in this article. Relevant links are included so that you are able to corroborate mentioned treatment options and use diagnostic tools.

How did you obtain diagnosis?

This question came up several times, with many of you saying you had tried and failed to have PMDD accurately represented when speaking to GP’s and medical staff. In my experience from discussing PMDD within the online community I have come across similar tales and it’s one that follows a similar trajectory to that of my own experience. I first suffered from mental illness at aged 13, suicidal ideation, attempts and thoughts occurred, followed by bouts of extreme rage, panic attacks and enduring anxiety. It wasn’t until some years later I had made the connection between my feelings and my menstrual cycle. I remember seeing a GP aged around 19 when I said I believed I was suffering from a hormonal imbalance. I didn’t know at this stage that PMDD is a reaction to normal hormone fluctuations, an imbalance was my assumed interpretation. She told me all women suffered ‘some PMS symptoms’ and that there was no diagnostic blood tests that would give insight into my mental health and it’s correlation with my cycle. Since then I have seen the GP and several gynaecologists in excess of 100 times for the same problem. When I finally began to be taken seriously around age 23, my GP still referred to my condition as severe PMS. Last year aged 33, I became so unwell during pregnancy and after the birth of my son that I was hospitalised and it was only then, under psychiatric care that a psychiatrist referred to my illness as Premenstrual Dysphoric Disorder. More recently this year when seeking further intervention privately, the Gynaecologist (whom is also head of his department in an NHS hospital) again confirmed a PMDD diagnosis.

Diagnosis is a huge relief, it allows us to stop gaslighting ourselves into believing we are raging hypochondriacs. BUT clinical diagnosis is not necessary for treatment of the condition. Your GP can advise, and treat PMDD symptoms even whilst still referring to it as PMS. If these early treatments such as lifestyle changes, hormonal birth control and SSRI’s work for you, you may never need a formal PMDD diagnosis. That’s not to say you won’t want one for your own clarity. If this is important to you, I suggest keeping on at your GP for specialist referral. If you are struggling to get a diagnosis and believe you have PMDD please head over to IAPMD for help and information on diagnostic criteria and talking to your doctor. They have an array of tools to help you cycle track and a glossary of terms that will help you explain exactly how your condition affects you see: Iapmd toolkit.

You also have fibromyalgia, do symptoms of both conditions overlap?

In short, yes. In detail, a higher percentage of fibromyalgia sufferers are women. A symptom of the condition in women can include painful and heavy periods dysmenorrhea. It’s also known that many persons living with fibromyalgia will suffer mental health problems, so it’s my opinion and personal experience that it’s fair to say symptoms overlap. PMDD can trigger a flare up in fibromyalgia pain, more prominent and prolonged fatigue, as well as sensory overload, brain fog and migraine attacks. The key difference between the two is that PMDD only occurs during the luteal phase of the menstrual cycle, which occurs between ovulation and menstruation. Instead, fibromyalgia symptoms can and do occur at any time during the menstrual cycle. I am often alerted to the arrival of PMDD by waves of crippling anxiety and intrusive thoughts that disappear when my period arrives. However some physical symptoms that might be triggered by PMDD end up lasting long after it’s end and will alert me to a Fibro flare up. Also with my experience of fibromyalgia, pain doesn’t ever disappear entirely. I always have some form of baseline pain. Many people also report joint pain with PMDD along with migraine attacks, these are present premenstrually as a result of PMDD and can occur and worsen at any time with fibromyalgia.

Can PMDD come on at any time in life?

Yes, it absolutely can. Some people find their PMDD starts or worsens with a reproductive event, such as menarche (which is when mine started) after pregnancy/birth or miscarriage (when mine worsened) or with the onset of perimenopause. For some it will seemingly come from nowhere. It is believed that PMDD can also be linked to genetics, childhood trauma and depression.

Is PMDD a disability?

Here in the UK, you are covered under the Equalities Act and therefore thought to have a disability if you have an impairment that is either, physical or mental and the impairment has a substantial, adverse and long term effect on your normal daily activities. Depending on the severity of your symptoms you could be covered under the act with a PMDD diagnosis. When explaining PMDD to my employer I advised how it affects me, for example: I suffer menstrual migraine attacks that leave me bed bound for days, along side extreme fatigue and joint pain. As well as this I also suffering debilitating anxiety, intrusive and suicidal thoughts and panic attacks, which make carrying out daily activities impossible. Cognitive impairment such as brain fog and an exacerbation of any underlying symptoms are also worsened with the onset of PMDD. The fact these symptoms occur every month, and last for 2 weeks makes this a long term condition with substantial impact on my life and ability to function.

Why do doctors prescribe SSRI’s for PMDD if it’s hormonal?

After diet and lifestyle changes SSRI’s are a treatment option to help manage the mood and anxiety symptoms that are present with PMDD. Whilst you may feel you aren’t depressed, some women (myself included) have found benefit in taking SSRI’s, both month round and only or double dosing during the luteal phase of your menstrual cycle.

Are palpitations a symptom of PMDD?

PMDD has many, varying symptoms. They range from severe mood alterations, to debilitating physical symptoms. I personally do experience palpitations during both ovulation and the luteal phase. I’m also extra sensitive to stimulants such as alcohol, sugar and caffeine during this time. All of which make palpitations worse and more noticeable. If palpitations are persistent it’s always best to get them checked out to rule out other possible causes, though I know many people experience them alongside profound anxiety, so if this is one of your PMDD symptoms it could also be exacerbating your palpitations.

Summary

  • PMDD is a chronic and debilitating condition with a range of symptoms that vary in severity.
  • There are a range of treatments used to treat PMDD and their effectiveness is very individual.
  • PMDD can and does exacerbate underlying conditions, this is sometimes referred to as PME (premenstrual exacerbation)
  • PMDD can occur at any time during a person’s menstruating life.

I hope this information is helpful. For more detailed and expert advice head to IAPMD where you’ll find everything you need to learn more about PMDD.

HRT to treat PMDD – Week 5

August 17, 2022 — 1 Comment

This week if I had to use 3 words to sum up my HRT experience I’d use: BLOODY, ENTHUSIASTIC and BRAVE.

Bloody

I’m still bleeding two weeks after the last time I told you I was bleeding. Which isn’t ideal. It’s not spotting either, it’s a couple of pad changes a day. The main cause for concern here is I can’t really tell what is or was my menstrual period and so I don’t know my cycle as I normally would and therefore struggle to determine how my symptoms relate to which phase. However, for now, I’ll take the blood. I don’t want to put up with it forever, of course that would become troublesome, but so far the blood I’m losing is a minor problem and is being outweighed by positive changes and more calm.

I’m also unsure whether this bleeding is related to the oestrogen gel, or the progesterone in the mirena coil as both report similar effects. It still needs noting though, because it is a troublesome symptom if it continues long term, and I don’t want to have to add an additional progestin treat it.

Enthusiastic

I chose this word because for the most part it’s how I’ve felt in the last two weeks. Potentially this suggests it’s when I’d usually be in the follicular phase, or that HRT is doing the job it was prescribed for. The trouble with me is, I am a pessimist, after decades of cyclical hell I’m almost programmed to think it can’t be working. However if I’m being honest, with both you, and myself, I have felt better, less anxious and more able to cope. It’s summer holidays -I mean if there was ever a time that was going to tip me over the edge this would be it! But I’ve managed to get out with both kids, I’ve caught up with friends (just having the energy and enthusiasm for this, is hugely positive) In the last few days I’ve suffered migraine attacks and felt fatigue and muscle pain (which I think is related more to Fibro than PMDD) and still my mood hasn’t plummeted. Moreover I’ve not been plagued with those awful intrusive thoughts. All of this, for me, is quite something!

Brave

I chose this word because I have done things I’d usually panic doing, like driving places I don’t know, on my own, and trying to get my steps up, increasing my movement. I’ve still had anxiety around doing these things, it doesn’t just disappear, but it’s anxiety in relation to normal life stuff as opposed to being crippling, as is normal during PMDD.

Gynae Appointment

I saw the gynaecologist to discuss my treatment plan and review my use of HRT. He got full marks as soon as I entered, when he thanked me for my email. I was relieved to hear that he had taken the time to read it, it was long! I explained all of my symptoms to him over the past two decades. He asked me how I cope during PMDD and I explained to him that for the most part, I don’t. Some would argue this, but I am forever calling on my mum and husband to come and help with the kids or indeed in a panic that they then have to talk me out of. I told him I’ve been in crisis so many times premenstrually that I almost feel it’s normal. That I swing from feeling like ‘I’m going mad’ to being able to cope. He fully supports a PMDD diagnosis. To be honest just hearing those words as opposed to the ‘severe PMS’ my GP always uses was such a relief that I ended up leaving in tears.

What was even more positive for me was the options he presented me with. Just finally feeling as though I have some was effectual in calming my racing mind! I’ve always known the treatment pathway, I’ve just never been able to get a doctor to consider me for the next stage before now!

We concluded that I will remain on the HRT for another few months unless I do not see any continuity with the improvement, or I experience a relapse. The next phase is chemical menopause which is induced by injection of GNRH analogues. As it’s an open referral to a private hospital, it’s left open so I can call him any time and book the next available appointment for the GNRHA shot. If I go down this route I will leave the mirena in situ and continue to use Oestrogel. I would then trial the medication for 6 months before deciding whether or not to have surgery to remove both of my ovaries and Fallopian tubes (Bilateral Salpingo Oophrectomy)

No major surprises at this appointment I knew what was to come next, I just thought I’d have to fight harder for it. Relieved to say I didn’t. The consultant explained that to obtain the injections for chemical menopause, I would need to have the first one in secondary care (Private treatment centre) and then I could be referred back to primary care to receive the injections on the NHS. This was really reassuring considering my mum paid for my appointment and I have £14 in my current account, so there’s no way I can afford private healthcare in the longterm. That said it was still worth every penny to us as a family, to enable me to have these discussions with a knowledgeable doctor whom is experienced in Premenstrual Disorders. I feel like there’s hope, and options and both of these were in short supply before my appointment.

I plan to write another blog really soon to answer questions relating to PMDD, but please remember IAPMD are the oracle when it comes to premenstrual disorders, so head on over there if you need advice, questions answered, or resources to support you.

HRT to treat PMDD – Week 3

August 3, 2022 — Leave a comment

If I could sum up the last three weeks in three words they’d be INSOMNIA, ANXIETY, and HOPE.

Insomnia

So let’s start by telling you about the insomnia. I’m not going to sugar coat it, it’s been horrific. It began almost as soon as I started using Oestrogel and unfortunately it remains. If you’re reading this, you’re probably a HRT user yourself, menopausal, someone who thinks they may have PMDD or a PMDD sufferer. Or maybe you’re none of the above and have no previous insight into hormone replacement therapy at all… I know it can be confusing when deciding whether or not to try a new treatment, especially with how the media portray HRT as either a wonder drug (and for many it is) or a carcinogenic. But like with anything we put into our bodies, there are side effects to consider. For me, insomnia has been one of the most problematic. As a mother and someone whom lives with chronic fatigue and on occasion hypersomnia, I have found this particular symptom difficult to navigate. Mainly because, if you’ve ever lived with insomnia you’ll be aware of how it can feed into anxiety. Just how dark the depths of the night can become when sleep is evading you.

Anxiety

Since beginning HRT I’ve had loads more energy – which to some would be deemed a positive side effect. However, for me it’s not been so good, because the energy I seem to now have in surplus, is creating a quagmire of anxiety and ‘nervous tension.’ In short – I can’t relax. I’m feeling often keyed up and on edge.

A few other notable side effects have been:

  • Hot flashes
  • Nausea
  • Breakthrough bleeding – though this could be attributed to the recent mirena coil I now have in situ.

Hope

But I’m still hopeful…. Mainly because what else have we got if there’s no hope? And also because it’s very early days and adding in additional hormones was always likely to cause some symptoms particularly when you’re adding them to treat a hormone sensitivity and not necessarily a depletion as you would in menopause.

I’ve also just finished reading I BLAME THE HORMONES by Caroline Suzi Church and that gave me hope. It’s something I want to review on its own blog post, because the similarities between mine and Caroline’s PMDD trajectory are so similar, it’s more than I can possibly squeeze into a paragraph on this blog, but if you have PMDD you absolutely need to read it! Not only is it scarily accurate, a whole half of it is dedicated to treatment and self help. It really is a wonder of a book with so much insight into reproductive mental illness.

Positive changes

Finally, I need to finish by saying there have been some positive side effects, though fewer, it’s important for me to be transparent. Many people have great results using HRT and as mentioned above I am still really hopeful that I too, will get to experience more of these going forward. One positive change I’ve noticed is a reduction in the severity of my overall joint pain. Which is pretty huge considering I’m in pain almost all of the time. I’m not pain free now by any means, but my joints are beginning to allow more range of movement and I can only attribute this change to coinciding with my use of HRT. Another thing that’s improved is the horrific intrusive thoughts I was having. They are not gone altogether, but when it comes to feeling out of my mind I’ll take every single win (however small) I can get and this is one that suggests HRT could be the right direction for me.

HRT to treat PMDD – Week 1

July 22, 2022 — Leave a comment

What is Oestrogel?

Me holding an Oestrogel pump pack

Oestrogel is a transdermal oestrogen supplement that is used to replace lost hormones during peri menopause and menopause. It’s also less commonly used to suppress the ovarian cycle in the treatment of Premenstrual Dysphoric disorder, which happens to be what I am using it for. After twenty years and many, many attempts at treatment, including antidepressants, birth control and birth control induced cycle suppression, my symptoms have, over time, bettered and then worsened again. After giving birth to my son in 2021 and suffering severe perinatal mental illness, I noticed an increase in the severity of my PMDD symptoms. Symptoms included intrusive thoughts, suicidal ideation, anxiety, and brain fog. Along with exacerbation of physical symptoms; frequent migraine attacks, perennial fatigue, recurrent shingles outbreaks and an increase in fibromyalgia associated musculoskeletal pain. My doctor, (after some persuasion) finally got advice from gynaecology who agreed to proceed with Oestrogel as a treatment, providing I had a mirena coil fitted which contains localised progesterone to protect my uterus from hyperplasia. Please note it’s strongly advised you discuss the use of add back progesterone with your health care provider in the treatment of PMDD.

Treatment pathway for PMDD

Below is the treatment pathway for UK patients. You can find out more detailed information by visiting IAPMD or NAPS for resources.

How to apply the gel.

There are various ways to apply Oestrogel, for most women, application to the upper arms is the easiest and preferred method. I was specifically advised by my doctor not to apply above the waist due to the other health issues I have, and therefore, I apply my Oestrogel to the inner thighs, one pump to each. Rub the gel over a large area leaving a sheen on the skin and then allow to dry before getting dressed. It’s important not to apply too close the the genitals due to the absorption differences in that area, or breasts, because of the oestrogen receptors present there. I was also advised to apply the gel at roughly the same time each day.

How’s it going?

I’ve been applying this gel everyday for a week and I’ve felt pretty rubbish if I’m honest. I’ve experienced saturating night sweats, insomnia, nightmares, nausea, migraine attacks, plus prominent feelings of anxiety and agitation. However – and this is important; looking at my cycle tracker I felt the same on these days last month. Aside from the night sweats and insomnia, last month at this exact time, I reported feeling ‘keyed up’ suffered a three day migraine attack, and felt particularly unwell requiring a day off from work. I also believe some of my current anxiety could be directly related to my personal fear of negative side effects. I did ask my GP the likelihood of a worsening in symptoms upon starting the HRT, and she said it was unlikely to have a result on mood – she knows pretty much nothing about PMDD so naturally I did my own research and pulled the below reference from the late Prof John Studd’s clinic website, referring to the use of transdermal oestrogen in the treatment of PMDD:

Ovulation can also be suppressed by moderately high dose transdermal oestrogens in the form of oestradiol patches or oestradiol gel. Appropriate doses would be a 200ugs oestradiol patch or 2 or 3 doses of oestrogel twice daily. Woman may occasionally feel a little worse in the first two weeks on this high dose, like an early pregnancy, but should be advised to continue as substantial benefit is almost certain if the diagnosis is correct.

John Studd Women’s Health Clinic

I found this reference particularly relevant because I said to my husband just yesterday that I feel almost exactly like I did in early pregnancy, and that was bad!

Moving forward

There’s a fair amount of controversy about the long term use of HRT particularly for women who are not yet experiencing symptoms of menopause. That said, it’s not a short term fix either, my doctor advised I need to give the Oestrogel a minimum of three months at the current dose before deciding if it’s of benefit. So I’ll continue, and aim to update you fortnightly going forward. I also plan to save enough money to visit a private gynaecologist, because sadly as we know the NHS is not doing so great and the wait times for appointments when you’re feeling suicidal or experiencing symptoms so debilitating it’s affecting your everyday life just aren’t acceptable. If you’re wondering how I can afford this, the answer is, I can’t afford it, but nor can I continue to live through this hell. Wish me luck. 

Disclaimer: Every PMDD patient will respond to treatment differently. In the writing of this blog I aim to provide an honest account of my personal experience. Although this post contains hyperlinks to official medical resources, it does not constitute medical advice. My experience is individual and yours will be too. Please see your healthcare provider to discuss all of the treatment options available to you.

Disability Pride

July 14, 2022 — Leave a comment

Disability Pride Month can mean various things to each individual in the disabled community.

Some people may see the month as a time to celebrate their individual success and accomplishments, whereas others may celebrate the feeling of pride about being disabled.

https://www.inclusiveemployers.co.uk

Have you heard about Disability Pride? Honestly, it wasn’t until a few years into my diagnosis that I first heard of it myself. Though I think that’s because I wasn’t referring to myself as disabled back then, despite spending weeks at a time in bed, wracked with pain and requiring months and months off from work. Unable to function without help, everyday activities became once in a blue moon activities. There have been many times over the last six or so years that I’ve been too unwell to dress myself or shower. Not as a one off, but consistently for long periods of time. At times I’ve been too disabled to work and to walk. My own disability pride has arrived, but only after battling years of internalised ableism.

I was once a person that believed disabilities were -for the majority at least- visible. I believed you had to have a permanent wheelchair or an aid, a prosthetic or an obvious disfigurement to be considered disabled.

I believed if you were depressed you had to look depressed (whatever that looks like) Despite myself suffering from mental ill health since childhood, I still had this idea that mental illness meant being obviously and outwardly ‘crazy.’ (I use this term to poke fun at my own misconceptions and it is not intended to cause offence.)

I’m here today to say, I was wrong. Not only was this way of thinking disrespectful to minority groups including those with disabilities, it was wholly inaccurate, and it was disrespectful to myself. I spent a lifetime playing down my own experiences, symptoms and health issues, because there was no way I was possibly suffering as much as someone else. But there’s an issue with the notion that other people have it worse and therefore we must ‘suck it up’ and the issue is that it’s harmful. It’s harmful because it attempts to invalidate a person’s suffering. Someone will always have it worse, we know this without a doubt, but to apply that to a person’s suffering (including your own) leaves us open to discrimination, feelings of shame and guilty whilst also furthering to escalate mental health issues.

Disability pride means celebrating all disabled persons regardless of the severity of their disability or it’s visibility. Not everyone who becomes disabled will remain so forever, though many people with chronic and ongoing illnesses will be impacted enough by their conditions to be considered disabled.

You’re disabled under the Equality Act 2010 if you have a physical or mental impairment that has a ‘substantial’ and ‘long-term’ negative effect on your ability to do normal daily activities.

https://www.gov.uk/definition-of-disability-under-equality-act-2010

My battle with internalised ableism is an ongoing one. Despite feeling more comfortable, open and able to discuss my health and it’s effects on my life, I still feel some guilt around doing so. I feel as if I am seen to be attention seeking if I tell the truth about how my illnesses affect me. There’s a real crossover between being positive and not focusing on all of the things you can’t do, and downplaying symptoms to appear more positive to the outside world.

In 2020 around 20% of the working population reported disabilities. This number, though higher than previous years, is still disproportionately low, considering more than 1 in 5 of us are affected by disabilities in the UK. It is unfortunately more likely that disabled people don’t feel able or comfortable disclosing their disability to their employers. Disability pride is a great way to celebrate disabled people for whom we are. As well as raise awareness, and shine a spotlight on discriminations such as the disability pay gap and lack of world wide accessibility in the work place.

The purpose of DP is to highlight that a disability can have a significant impact on a person’s life, whatever the cause and regardless of its visibility. It also encourages more people to be proud of their disabilities. Perhaps you’re like me, and find it hard to pride yourself on things that have felt traumatic, debilitating and painful. Or perhaps you are proud of how far you’ve come, in spite of, or alongside your disabilities. Perhaps, you’re just proud you’ve managed to stay alive. And that’s ok too.

Disabled people are almost twice as likely to be unemployed as non-disabled people, and 3 times as likely to be economically inactive

https://www.scope.org.uk/media/disability-facts-figures/
Disability Pride Flag
The charcoal background – to represent those in the community who have been subjected to ableist violence, as well as representing protest in the community.
The “band/road” shape – represents how disabled people face barriers and have to navigate their life according to them. The different colours in the shape represent the creativity in navigating life, and how the community is breaking free from stigmatisation.
The colours – represent the various experiences and needs (mental illness, developmental disability, invisible disabilities, physical disabilities and sensory disabilities) in the disabled community.

There are many ways you can still get involved in disability pride month. Sharing on social media, writing your story, and talking to your employer about supporting disability pride, are all great places to start.

Confessions of a chronically ill mum #17

June 20, 2022 — Leave a comment

It feels as though the last week has been littered with extremes. I have felt full all the emotions. Health has been quite poor, a migraine attack the weekend saw me in bed for three days. The longest I have been out of action for a while. To make matters worse I was due to be out with mum and friends yesterday and had to cancel. I’ll never get over the sinking feeling of firstly, having to let people down, and secondly, serious fomo at having your life made smaller because of illness.

I’m waiting for a call from the doctor regarding my referral for a more detailed treatment plan for PMDD. At the moment despite taking medication and birth control I seem to have fallen back into a fortnightly switch. Meaning, I get two goodish weeks, and two that set me on fire with the flames of hell. (Not an exaggeration) My anxiety has been so palpable the last two weeks, coming at me in waves, and I’ll confess, there’s been a few incidences where I’ve felt really terrified, again. Terrified that all it’s going to take is that one hormonal cycle that tips me over the edge and into madness. For those of you that think I’m already over that edge… Hun, you have no idea!

A few things have been niggling at me for a while – like Kaiser’s birthday and feeling some panic around what I remember from hospital and his birth. Those feelings of insanity and desperation- and PMDD seems to bring those niggles into the spotlight. I’ve tried again to write Kaiser’s birth story but it just too painful and triggering for me to go back there, it’s also too long! So much happened in those ten days I was in hospital, every-time I think I’ve told the story, I remember more, and it’s mostly hell.

Another thing PMDD does, is make my physical health so much harder to manage. This week I’ve had hives, migraine attacks, nausea, all over body pain in the extreme, and profound fatigue like someone has pulled the plug on my body and it cannot function until it’s recharged, which isn’t as easy as just getting some rest, when you’re a mum!

I think I mentioned quite recently that I’ve been working really hard on trying to be more consistent with my blog. I’ve also had a couple of other writing projects in the pipeline. I’ve had a few rejections too, which have been quite hard for me to move past. Not because I think I’m better than I am, but because it takes so much energy to be creative that when it doesn’t pay off as you hoped it would, it can be disappointing in a much more personal way. As I said, hormones don’t help my mood and undeniably influence how I perceive rejection whilst in luteal. It’s funny though, I’m writing this today after a hellish migraine, and there’s some pattern to me feeling a need to write after an attack. I have no idea if there’s any scientific evidence to suggest the brain becomes more focused after migraine, but for me, it seems fitting.

It’s been mentioned to me that I seem fixated with my hormones lately. And looking back at my last few COACIM it would appear to be true, I am fixated. However, I don’t think it’s just lately. I’ve always been obsessed with them, because of their insurmountable affect on my life. But I will confess again, that since having Kaiser they have felt magnified and I am both distraught and fascinated at how the fluctuations of hormones affect me (and one in twenty other women, too.) It’s hugely important for me to raise awareness of hormones and their effects on health, mental health in particular. So this is one fixation that’s here to stay. So much so, my next blog post is going to be about why you should track your menstrual cycle.

Also this week, I spoke to Enable magazine about living with Fibromyalgia and the impact of the condition. The lack of support during covid, for people in chronic pain, along with the changes to NICE guidelines and the prescribing of pain relief. The publication hasn’t gone live yet, so I don’t know how accurately I’ve been quoted, but when it does I’ll definitely share.

Finally, the kids…. Kaiser has been having tummy troubles since transitioning to cows milk and this has further affected his already crap sleep. And Ciara, well, she’s been her own kind of emotional. She is such a good kid, but communicating with her can be difficult at times. I notice she isn’t like me in my directness, she can hold back and that can make me panic, thinking there could be something going on she isn’t telling me about. However I also know, I need to learn not to push her too hard, together we are navigating this new stage and trying to respect each other’s feelings. It’s a whole new world, and finally I’m about to say something I never normally do…. She’s growing up too fast!

All in all, I’d say this has been a below par seven days. Life has felt harder, but in keeping with trying to retain some positivity, I am confident it will improve again soon. For now though I’ll leave you with some pics of the kids, because they may be enough to cheer someone who may have also had a shit week, up!

Almost one, not a fan of the sun 🌞
We chose to visit a man made beach on the coldest day of the week

Reasons You Should Track Your Menstrual Cycle

June 20, 2022 — Leave a comment

One of the things I get asked occasionally when discussing PMDD and how I manage it, is how I track my menstrual cycle. Now, I know, as a writer, I should probably favour good old fashioned pen and paper, but instead I prefer to use an app. It’s quick and easy, and all the information you need is available at your fingertips. I’ll go into more detail about which app I use and why, shortly, but first a few reasons why you should track your menstrual cycle.

THE WHY IF YOU HAVE A PREMENSTRUAL DISORDER….

There are many reasons why you might wish to start tracking your menstrual cycle, or maybe you haven’t been considering it previously at all. Either way, here’s a few core points as to why you might start. Not all of them are relevant to PMDD, but if you do have PMDD see this as a reminder that in order to gain access to adequate treatment, and or diagnosis, you really need to have tracked your cycle for a minimum of two months (or two previous cycles.)

The reason being, cycles as we know, change, with hormones fluctuating regularly. When living with PMDD specifically I would (personally) recommend cycle tracking to have taken place for a minimum of three to six months. Because, as a consequence of hormone fluctuations, symptoms will too fluctuate and it’s important, for diagnostic purposes, to note the severity in symptoms and whether they occur frequently or ad hoc. It’s also useful for you individually to note how long your PMDD episodes last, their impact on your life, and whether normal every day activities are compromised. PMDD doesn’t only come with psychological symptoms, despite it being a hormone based mood disorder. Many persons with PMDD also experience a range of more prominent physical symptoms than those with PMS. And all of that’s without really delving into the influence they have on our moods and mental health. IAPMD recently published a study showing that an alarming 34% of persons with a menstrual disorder such as PMDD will attempt suicide. If you have been feeling depressed, anxious or dealing with intrusive thoughts, see a health care provider as soon as possible and start cycle tracking. It’s a really useful tool in determining if your symptoms could be related to, or be exacerbated by hormonal changes and your period.

THE WHY IF YOU HAVE A NORMAL CYCLE….

If you’re someone who has never experienced menstrual health issues, you might be wondering why you’d bother to track your menstrual cycle. Surely if your period arrives like clockwork every month with minimal impact on your life, cycle tracking is an unnecessary chore? Well…not necessarily. The purpose of tracking your menstrual cycle is a personal one, but many people still want to get ahead of aunt Flow’s monthly visit, and keeping track is a great way to do it. You may be planning a holiday in advance and having tracked your cycle for the last few months is more likely to give you an accurate prediction of when a future cycle is likely to end and your period start. You may be keen to learn when you’re likely to ovulate. Again, this is more likely to be accurate if you are regularly keeping track of when you bleed. Many people now use cycle tracking as a medicinal birth control alternative, as well as when planning pregnancy. Perhaps your period has always been regular but now isn’t. Could you be pregnant? Is it peri menopause or even menopause itself? You might also be experiencing symptoms that you are completely unaware could be caused or exacerbated by hormonal fluctuations. Did you know common illnesses such as colds and sort throats can also be caused by hormonal changes including being premenstrual? Learn more about ‘period flu’ here. It’s even possible you’ve developed random hives, or your hay-fever is much worse. When you are cycle tracking though, looking back at the calendar you can pinpoint when this is likely to occur in future and potentially prevent the impact. Perhaps your migraine attacks have worsened or increased despite avoiding your usual triggers. Aches and pains have been bothering you, and fatigue is something you’ve been sure is just ‘normal tiredness’ but has become overwhelming recently.

Hormones affect so much of our bodily functioning and have the power to better or worsen how we feel much of the time. Without tracking your cycle it’s simply impossible to know if physical symptoms you could be putting down to everyday problems, are actually linked to hormonal fluctuations, imbalances, sensitivities, and in some cases more serious illnesses such as PMDD, endometriosis or poly-cystic ovarian syndrome and even some cancers.

HOW DO I TRACK MY CYCLE?

There are infinite ways you can cycle track. Of course, as previously mentioned, good old fashioned pen and paper AKA a wall calendar or diary, will suffice. Just be sure to be consistent with diarising your symptoms and how they affect you. Specific menstrual health diaries are available to purchase on Amazon too.

The reasons I personally choose to track using an app are: it’s quicker, you can set reminders to prompt you to log symptoms, and even add medication prompts on some. Ovulation prediction is easier via an app too, it does it for you based on your previous two cycles. The App I use and have always used is simply called Period Tracker and is free via AppStore it has all the above features and also includes a place to diarise what’s going on, or leave yourself notes. Other common favourites seem to be FitBit and using your phone’s built in calendar, adding emojis to describe mood and notes for symptoms. There are so many to choose from though, plenty of options to make finding the one that works best for you easy!Typing in key words such as menstruation or period in your preferred App Store will allow you to see which ones are available on your device. As ever the infinite wealth of resources available via IAPMD is also a fantastic place to start. They have a self screen tool for people who feel their symptoms could be related to PMDD or PME. Diagnostic criteria and advice as well as symptom tracker sheets specifically designed for PMDD. You can access all of their resources via this link

I personally use a cycle tracker to prevent, reflect, prepare and manage my periods and their impact on my life and abilities. It helps me understand why I might be feeling a certain way and is also a useful tool when presenting symptoms to healthcare professionals. Good luck, ‘appy tracking! 

Disclaimer: Everything mentioned in this post, including the links and suggestions, are my own personal experiences, opinions and preferences, and are not affiliated in any way with the websites or brands mentioned.