Need more time with your doctor?

Need more time with your doctor? In today’s hurried world both the doctor and the patient can feel frustrated by the amount of time available to speak with each other. Did you know that the insurance company rarely pays for more than a 15 minute visit with a primary care physician (PCP) unless the patient has a diagnosis they think should take longer. Even then extra documentation is required to show why it would take so long. Its ironic that they pay specialists for more time (even when it is a pop in and “keep taking the same medicine” visit) than they do for PCP’s who are supposed to be on the frontline and have a deeper understanding of you and your family’s overall health. I recently admitted a critically ill patient who had just returned from overseas and the insurance company refused to pay for my hospital visits to take care of him. Even though they saved a bundle by not having to pay specialists. They said his care is covered by the $20 a month they pay me for capitation. Small wonder most doctors don’t bother to take care of their own patients in the hospital anymore. They simply turn them over to a hospitalist who doesn’t know anything about them, kind of like a mechanic who only handles exactly what is in front of him. I recently returned from a conference (way out in the Boonies!) on alternative medicine and once again learned fascinating information I would love to share with my patients. But where is the time? While I am at conferences I keep thinking “wow! So and so may really benefit from that”. “I wish I had known that before so and so had that surgery” “I have a zillion patients who complain of fatigue, fibroids etc…If only I could have more time with them” When I come back I always like to meet with my VIP patients to discuss how new information may help them and what changes we can make to their vitamin regimens. Unfortunately I cant do that with everyone, however, if you feel that you would like to schedule a private self pay consultation with me please call the office. I am bursting to share the great news of how to improve health with everyone. Believe me my own regimen changed last weekend! Here’s to real health and vitality.

Peri-menopause is a tough one!

It has been my experience in the last 20 years that the Peri-menopausal period is actually harder than menopause itself.
I want to discuss some of my theories as to why this is so, but first what is Peri-menopause?

Peri-menopause is defined as the time during which a woman's body transitions into menopause, it can be from 6 to 10 years and ends 1 year after a woman has had her last period. It usually starts to occur in the 40's.

Many women are taken by surprise when they begin to experience peri-menopausal symptoms as they are unfamiliar with this phenomenon. Often they expect the cessation of their periods to be the first sign. Whereas period irregularities are often an early sign, they are more likely to become erratic and varied, longer or shorter in length and different each month.

Peri-menopause is a time when hormone levels are fluctuating wildly, and the changing symptoms demonstrate this. Moodiness and depression may set in because of unaccustomed feelings, people who have never had headaches before can develop migraines. The memory declines but not consistently and women may begin to feel a little 'fuzzy' and very vulnerable. The latter occurs particularly in professional women who are used to being able to make split decisions. And then there's the weight gain ! Almost invariably across the board there is more deposition of truncal fat in spite of regular exercise and weight control methods.

Inconsistent sleep and night sweats cause a lack of rest and this adds to the irritability and depression, women find themselves anxious for no specific reason and may lose their motivation.

Changes in the sexual arena can also be expected and once again may fluctuate with hormone levels.

Remember that this is also a transition for families who are suddenly surprised at the changes in a woman's persona but often are too tactful to mention it. The people around you are a good barometer they tend to notice a whole lot more than you give them credit for!

So why is it so tough?
Well, first of all because it is unexpected, it seems so sudden there is no time to adjust. It often occurs at a time when the woman has a lot of responsibilities, having achieved a certain professional level with a completed family to take care of. Stress is a huge aggravating factor in Peri-menopause and the sudden overwhelming sense of not being able to handle things is very common. For many women this is the first time they have ever had 'anything wrong' with them.

Secondly, it is not often discussed so women don't know where to seek help, they may not even be aware that there is help and so this generates a feeling of isolation. A reluctance to discuss the symptoms while attempting to handle it by themselves. They are not alone! Millions of women have the same problem they just dont talk about it. Whereas the syndrome of Menopause is well known the precursor is not.

Lastly, there maybe a sense of loss, women know something is changing and it may not be a state they are ready for. they know intuitively things will never be the same again. Skin changes, memory changes, lots of gas, dizziness and joint pains may also accompany this condition. One thing is for sure these are physical and physiological changes, its not all in your head!

In my next blog I will discuss ways to deal with these symptoms and how to improve the quality of life as you proceed to menopause.

Be well, lively and healthy until next time.........................

Dr Tuakli