Latest / Clearly Hormonal / Ep 04: Self-Aware is the New Self-Care: Navigating the Overlap Between Menopause and Stress

Transcript

Ep 04: Self-Aware is the New Self-Care: Navigating the Overlap Between Menopause and Stress · Clearly Hormonal

• 0:01
  Dr. Komal Patil-Sisodia: Welcome to the Reset Recharge podcast with your host, Dr.
• 0:05
  Dr. Komal Patil-Sisodia: Komal Bhatia Sisodia, a board certified endocrinologist, internist, and obesity medicine specialist.
• 0:11
  Dr. Komal Patil-Sisodia: This podcast is focused on empowering women's health and aims to help you reset your understanding of your metabolic health.
• 0:18
  Dr. Komal Patil-Sisodia: And recharge the conversations you are having with your healthcare providers.
• 0:22
  Dr. Komal Patil-Sisodia: While I am a physician, this podcast is purely for educational purposes.
• 0:26
  Dr. Komal Patil-Sisodia: No individualized medical advice is being given on this podcast.
• 0:29
  Dr. Komal Patil-Sisodia: If you do find information that is helpful, please discuss it with your healthcare provider at your next visit.
• 0:39
  Dr. Komal Patil-Sisodia: Hi, everyone.
• 0:40
  Dr. Komal Patil-Sisodia: Welcome back to Reset Recharge.
• 0:41
  Dr. Komal Patil-Sisodia: I'm your host, Dr.
• 0:42
  Dr. Komal Patil-Sisodia: Komal Bhatia Sisodia.
• 0:44
  Dr. Komal Patil-Sisodia: I am really excited for this episode.
• 0:46
  Dr. Komal Patil-Sisodia: We are going to focus on self awareness around symptoms.
• 0:51
  Dr. Komal Patil-Sisodia: Women are often told that we can have it all, and it's really only in recent years that we've started to push back on that concept and explore the fallacy of it all.
• 1:01
  Dr. Komal Patil-Sisodia: Society tells us and endorses us so strongly that women often find themselves dealing with these feelings of self doubt and inadequacy and grappling with burnout because they can't have it all.
• 1:16
  Dr. Komal Patil-Sisodia: And it gets even harder as we approach midlife.
• 1:19
  Dr. Komal Patil-Sisodia: The lines between stress and perimenopausal symptoms really start to blur and you may find yourself totally unsure of which one is affecting your day.
• 1:32
  Dr. Komal Patil-Sisodia: Or whether it is, you know, both of them.
• 1:36
  Dr. Komal Patil-Sisodia: Symptoms are downplayed by both women and their doctors, which doesn't really make this journey any easier for anyone.
• 1:45
  Dr. Komal Patil-Sisodia: I was traveling recently, and I was in an airport that has one of those really steep escalators.
• 1:52
  Dr. Komal Patil-Sisodia: You know, the ones where if you look up or down, it makes you dizzy, and you might throw up.
• 1:58
  Dr. Komal Patil-Sisodia: Well, it also doesn't help that I have a huge fear of heights.
• 2:02
  Dr. Komal Patil-Sisodia: So, when I stepped onto that elevator, I was looking for any distraction I could find.
• 2:08
  Dr. Komal Patil-Sisodia: I looked around, um, for something to focus on and I, you know, just so I didn't pass out and fall all the way back down that escalator.
• 2:17
  Dr. Komal Patil-Sisodia: So I did the best thing I could in that situation.
• 2:19
  Dr. Komal Patil-Sisodia: I focused on the two ladies.
• 2:21
  Dr. Komal Patil-Sisodia: Um, I was standing directly in front of me and I eavesdropped on their conversation because again, desperate times call for desperate measures and I needed something to focus on.
• 2:31
  Dr. Komal Patil-Sisodia: Not my finest moment, but you know, these things happen.
• 2:34
  Dr. Komal Patil-Sisodia: So as they were both talking to each other, They kept talking about how tired they were between running between work, travel, family, sports practices, after school activities, workout classes that they were trying to squeeze in there.
• 2:51
  Dr. Komal Patil-Sisodia: But they were also so proud that they had achieved that level of busyness despite the fatigue.
• 3:00
  Dr. Komal Patil-Sisodia: One of the women actually turned to the other one and said, Well, I guess that's what we have to do if we want to be badass boss bitches.
• 3:10
  Dr. Komal Patil-Sisodia: Thankfully, we got to the end of that escalator ride just as they were wrapping up that conversation.
• 3:17
  Dr. Komal Patil-Sisodia: And as I walked to my gate, I kept replaying it in my head.
• 3:22
  Dr. Komal Patil-Sisodia: They both sounded so tired and actually a little resigned at all they had to do, despite all of the cheerleading they were, you know, doing for themselves and for each other.
• 3:34
  Dr. Komal Patil-Sisodia: It almost felt performative, like they had to convince themselves.
• 3:38
  Dr. Komal Patil-Sisodia: And the sad thing is, is in this modern day, we have so many competing priorities.
• 3:43
  Dr. Komal Patil-Sisodia: We have all, we all have full time jobs that vary based on our choices.
• 3:47
  Dr. Komal Patil-Sisodia: Some of us are full time homemakers, full time students, at a full time job, or a boss, and all of the above, right?
• 3:55
  Dr. Komal Patil-Sisodia: And some combination of it.
• 3:56
  Dr. Komal Patil-Sisodia: And we create these identities for ourselves that are based on what society, the media, our family and friends expect of us.
• 4:06
  Dr. Komal Patil-Sisodia: And those identities are constantly changing.
• 4:09
  Dr. Komal Patil-Sisodia: Who am I today?
• 4:10
  Dr. Komal Patil-Sisodia: Am I a partner?
• 4:12
  Dr. Komal Patil-Sisodia: Am I a wife?
• 4:13
  Dr. Komal Patil-Sisodia: Am I a mom?
• 4:13
  Dr. Komal Patil-Sisodia: Am I a sister?
• 4:15
  Dr. Komal Patil-Sisodia: A daughter?
• 4:16
  Dr. Komal Patil-Sisodia: A friend?
• 4:16
  Dr. Komal Patil-Sisodia: A resident badass boss bitch?
• 4:19
  Dr. Komal Patil-Sisodia: As our identities shift, our bodies are also shifting.
• 4:22
  Dr. Komal Patil-Sisodia: There can be a huge sense of loss as we transition in and out of these roles.
• 4:29
  Dr. Komal Patil-Sisodia: We're taught that we can have it all and that we need to do it all perfectly.
• 4:35
  Dr. Komal Patil-Sisodia: We're never taught.
• 4:37
  Dr. Komal Patil-Sisodia: And that change is the only constant and that our roles will change.
• 4:43
  Dr. Komal Patil-Sisodia: And then on top of that, so will our bodies.
• 4:46
  Dr. Komal Patil-Sisodia: We are conditioned to put others first without being aware of our own needs and limitations.
• 4:53
  Dr. Komal Patil-Sisodia: And I stress limitations because we all have them.
• 4:56
  Dr. Komal Patil-Sisodia: One of my patients said something really heartbreaking to me recently during one of our last visits.
• 5:02
  Dr. Komal Patil-Sisodia: I see her for an unrelated endocrine issue and the topic of menopause came up because her periods had stopped about a year and a half before and she was continuing to have persistent symptoms despite us optimizing her other endocrine condition.
• 5:18
  Dr. Komal Patil-Sisodia: She said, I don't even know who I'm supposed to be anymore.
• 5:25
  Dr. Komal Patil-Sisodia: My husband and I are empty nesters.
• 5:29
  Dr. Komal Patil-Sisodia: And our daughter needs us more as friends than she does as parents at this point in her life.
• 5:35
  Dr. Komal Patil-Sisodia: Work is going well enough, my marriage is great, but I'm trying to adjust to our new normal.
• 5:41
  Dr. Komal Patil-Sisodia: And I just feel lost.
• 5:43
  Dr. Komal Patil-Sisodia: I've worked so hard to get here, and I'm trying to pay more attention to myself and take better care of my body.
• 5:51
  Dr. Komal Patil-Sisodia: But my body is not cooperating.
• 5:54
  Dr. Komal Patil-Sisodia: I'm making all of these lifestyle changes and nothing is budging.
• 5:59
  Dr. Komal Patil-Sisodia: Some days I feel too tired to follow through because the effort doesn't seem worth it.
• 6:04
  Dr. Komal Patil-Sisodia: I don't even know who I am anymore and I feel forgotten.
• 6:09
  Dr. Komal Patil-Sisodia: This woman is a high achieving, resilient, wonderful human being and she has a great job.
• 6:17
  Dr. Komal Patil-Sisodia: She's been a great mother.
• 6:18
  Dr. Komal Patil-Sisodia: She has a wonderfully supportive partner and despite all of that she felt like she was just existing.
• 6:26
  Dr. Komal Patil-Sisodia: And our conversation brought up something important to me that I wanted to talk about today, which is the difference between surviving and thriving.
• 6:34
  Dr. Komal Patil-Sisodia: It can be really dark and isolating when you are just surviving and not feeling like you're thriving.
• 6:39
  Dr. Komal Patil-Sisodia: And I know that firsthand.
• 6:42
  Dr. Komal Patil-Sisodia: In 2015, my husband and I went through a life event that just rocked our world.
• 6:49
  Dr. Komal Patil-Sisodia: He had a heart attack, and I suddenly found myself on the hamster wheel to nowhere.
• 6:54
  Dr. Komal Patil-Sisodia: I was trying to be everything to everyone.
• 6:58
  Dr. Komal Patil-Sisodia: And that led me to some pretty significant burnout.
• 7:02
  Dr. Komal Patil-Sisodia: It took me several years before I even acknowledged it, and actually started working on things.
• 7:09
  Dr. Komal Patil-Sisodia: I'm pretty embarrassed to admit, and again, bless my primary care doctor who is the best, I tried to blame it on my thyroid.
• 7:15
  Dr. Komal Patil-Sisodia: Yeah, my labs were normal and she just kind of very gently told me that, you know, you know better, you know, it's not your thyroid.
• 7:22
  Dr. Komal Patil-Sisodia: And I, it took me so long to acknowledge that I was doing too much, uh, but it became evidently clear that this was all stress related.
• 7:31
  Dr. Komal Patil-Sisodia: So finally in early 2019, I signed up for this new coaching program for women physicians that is run by my dear friend, Dr.
• 7:39
  Dr. Komal Patil-Sisodia: Ali Navidzic.
• 7:40
  Dr. Komal Patil-Sisodia: She's phenomenal.
• 7:41
  Dr. Komal Patil-Sisodia: She's an obesity medicine certified physician and she creates these great programs focused on wellness and optimizing your lifestyle.
• 7:49
  Dr. Komal Patil-Sisodia: And previously they used to be only for women physicians, but now she's expanded it to non physicians.
• 7:55
  Dr. Komal Patil-Sisodia: So if you go to her website, which is called the fit collective dot com, you'll see just how wonderful her work is.
• 8:03
  Dr. Komal Patil-Sisodia: And signing up for her first program was actually my first step of self care.
• 8:07
  Dr. Komal Patil-Sisodia: Thank you And I was proud of myself for doing it, but when I got all the program materials, I looked at them and I got really overwhelmed because there were calls and workouts and things I had to read.
• 8:19
  Dr. Komal Patil-Sisodia: And I kept freaking out in my head thinking, I don't have the time to do this.
• 8:22
  Dr. Komal Patil-Sisodia: Like, I, I don't, I don't know how I'm going to do this.
• 8:25
  Dr. Komal Patil-Sisodia: And Allie is wonderfully firm.
• 8:28
  Dr. Komal Patil-Sisodia: And she pointed out to me that I was coming at this from a fixed mindset.
• 8:32
  Dr. Komal Patil-Sisodia: And she said to me, you are either the busiest woman on the planet.
• 8:37
  Dr. Komal Patil-Sisodia: Or you're not being honest with yourself.
• 8:41
  Dr. Komal Patil-Sisodia: She then had me write down everything I did for 48 hours, including when I was in the bathroom, when I was scrolling on social media, when I was driving to and from work, being at work, being with my family, and she promised me that I would be able to find time.
• 8:58
  Dr. Komal Patil-Sisodia: And she was right, I did.
• 9:00
  Dr. Komal Patil-Sisodia: I was doom scrolling on social media and watching TV after my son and my husband had gone to bed as attempts at self care.
• 9:10
  Dr. Komal Patil-Sisodia: In reality, I was just using it to block out how tired I was, and I was pretending that I was taking care of myself.
• 9:17
  Dr. Komal Patil-Sisodia: And because of that simple exercise, I actually started blocking time on my calendar for me, where I could make myself a priority.
• 9:25
  Dr. Komal Patil-Sisodia: I'm an early bird, so mornings work best for me before anyone else is up in the house.
• 9:30
  Dr. Komal Patil-Sisodia: And what I will do is block anywhere from 15 minutes to an hour, depending on what I can find early in the morning.
• 9:37
  Dr. Komal Patil-Sisodia: And some days I have meetings, so it just doesn't work quite so well, but at least 10 to 15 minutes where I can read and enjoy my coffee.
• 9:45
  Dr. Komal Patil-Sisodia: If I have more time, I fit in a workout.
• 9:48
  Dr. Komal Patil-Sisodia: And the wild thing is, is that on the days that I do this, I am so much more clear throughout the day and I am so much more efficient.
• 9:58
  Dr. Komal Patil-Sisodia: On days that I don't do it.
• 10:01
  Dr. Komal Patil-Sisodia: I'm not doing as great that day.
• 10:03
  Dr. Komal Patil-Sisodia: I'm dragging behind.
• 10:04
  Dr. Komal Patil-Sisodia: I'm not as upbeat and as energetic as I would like to be.
• 10:10
  Dr. Komal Patil-Sisodia: And so that was my first step towards self care.
• 10:14
  Dr. Komal Patil-Sisodia: And I want to underscore this point, which is being self aware is your first step towards self care.
• 10:23
  Dr. Komal Patil-Sisodia: I'm going to repeat that again.
• 10:25
  Dr. Komal Patil-Sisodia: Being self aware is your first step towards self care.
• 10:30
  Dr. Komal Patil-Sisodia: The reason that this is important is that the symptoms of stress and the symptoms of perimenopause Overlap, it's not even like a Venn diagram.
• 10:38
  Dr. Komal Patil-Sisodia: They're almost like superimposed circles.
• 10:40
  Dr. Komal Patil-Sisodia: You can have fatigue, mood changes, dry skin, hair loss, decreased libido, weight gain, all of the above, right?
• 10:49
  Dr. Komal Patil-Sisodia: And I will actually put a very comprehensive list on my website so that you can look through it at your convenience But it's important to know that they overlap and it's important It's important for us to start becoming self aware on this because knowing the trajectory of women's health in this country, we actually, in the medical profession, sadly, work extra hard to convince women that their symptoms are secondary to stress, and sometimes they can be, but we're not acknowledging that they could be due to perimenopause, and sometimes we don't know what the right thing to do is.
• 11:24
  Dr. Komal Patil-Sisodia: A few years ago, I had a patient in my office and she was having a panic attack.
• 11:28
  Dr. Komal Patil-Sisodia: She was convinced it was her thyroid.
• 11:30
  Dr. Komal Patil-Sisodia: Well, her labs, like mine, were totally normal.
• 11:33
  Dr. Komal Patil-Sisodia: But as we talked more about it and her symptoms, it came out that she was working 12 to 14 hour days and hadn't had a day off in four months.
• 11:44
  Dr. Komal Patil-Sisodia: We talked about why she was putting herself through that and it came out that she was scared that she would be replaced.
• 11:52
  Dr. Komal Patil-Sisodia: So she never said no.
• 11:54
  Dr. Komal Patil-Sisodia: Anything her boss asked of her, she did.
• 11:57
  Dr. Komal Patil-Sisodia: Her primary care doctor and I knew that this was not going to go well, so we talked to her and convinced her to take a medical leave of absence to focus on improving her stress.
• 12:08
  Dr. Komal Patil-Sisodia: She ended up coming back a few months later and was feeling significantly better, and she later ended up leaving that job for one that was less stressful and is doing really well now.
• 12:19
  Dr. Komal Patil-Sisodia: I fully acknowledge that she was really, really lucky to be able to do that, to step away from her job, and not everyone's circumstances will allow for them to have that degree of privilege.
• 12:33
  Dr. Komal Patil-Sisodia: And I think it's important to know that if you can't take a step back from a stressful situation, it's helpful to have a close friend or family member or your doctor help you walk through a timeline of when your symptoms started.
• 12:48
  Dr. Komal Patil-Sisodia: when the stressors began and whether the two correlate at all, right?
• 12:53
  Dr. Komal Patil-Sisodia: Because sometimes you can have symptoms that predate the stressors or vice versa.
• 12:58
  Dr. Komal Patil-Sisodia: On the flip side, I have seen patients whose symptoms don't line up with traditional endocrine disorders that I see in my office or improve after they take a break from a stressful situation.
• 13:11
  Dr. Komal Patil-Sisodia: And it's a bit easier in these patients to start discussing.
• 13:16
  Dr. Komal Patil-Sisodia: you know, overall health and could this possibly be perimenopause, menopause, and I'm speaking specifically around women who are in middle age, uh, to determine what next steps can be taken towards wellness.
• 13:31
  Dr. Komal Patil-Sisodia: This process requires engagement both from you and your doctor, and sometimes your friends and family.
• 13:38
  Dr. Komal Patil-Sisodia: So what are the takeaways from today's episode?
• 13:41
  Dr. Komal Patil-Sisodia: Number one, competing priorities.
• 13:45
  Dr. Komal Patil-Sisodia: and societal expectations make us less aware of ourselves.
• 13:50
  Dr. Komal Patil-Sisodia: Number two, busyness has become a status symbol and we have to be careful not to fall into that trap.
• 13:59
  Dr. Komal Patil-Sisodia: Number three, the symptoms of stress and menopause overlap and it's easy to cast one off as the other.
• 14:08
  Dr. Komal Patil-Sisodia: And then number four, It's important to pause and do an inventory and audit of your time and your symptoms.
• 14:17
  Dr. Komal Patil-Sisodia: Self care doesn't only mean mani pedis, massages, girls night out, wine tasting, taking more than a moment to pause and reset is one of the best things that you can do for yourself.
• 14:33
  Dr. Komal Patil-Sisodia: It can give you clarity and it can help you and your doctor figure out what is going on with your, with your life and your health.
• 14:41
  Dr. Komal Patil-Sisodia: And hopefully will help you find a path towards wellness.
• 14:45
  Dr. Komal Patil-Sisodia: So I appreciate you all taking time today to join me for this episode.
• 14:50
  Dr. Komal Patil-Sisodia: Thank you so much and I'll see y'all soon.