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Too Old for HRT#4. Breakthrough Spotting & Dosage Adjustments



 

It doesn't seem possible that my last blog on my HRT journey was on June 21st!

I planned to post weekly, but such is life.


OMG, July and August have been a crazy roller coaster ride. The journey that began as aching and arthritic knees took a turn for the worse on July 1st. That was the day I was finally scheduled to Go to physical therapy. Though I had been having trouble with my knees for a few months it was the first appointment available. I was scheduled for 2:00 PM. At 11:00 AM I was exercising our golden doodle, Frodo, throwing tennis balls for him to fetch in the pool—his favorite activity. I turned and stepped out of the pool. Stepping up with my right knee I drew my left leg out of the water, and I heard two loud pops, felt excruciating pain in my left knee, and landing awkwardly on the closest chaise lounge said a few choice words.

 

Off I went to the ER, two days later to the orthopedic knee doctor, two days after that the MRI imaging office. I then had to wait 10 days to get in to see the orthopedic doc again, for him to read the MRI. As luck would have it, in my previously sore left knee, I now have a 3rd stage tear of the meniscus. Big Ouch.

 

At the same time this was happening my husband was trying to schedule the replacement (revision) of his previous knee replacement, that had failed! Tim’s orthopedic surgeon wouldn’t schedule his surgery until my orthopedic surgeon decided whether I needed immediate surgery. Because of course, you can't have two primary caregivers for each other out with knee surgery at the same time because then there's no one to take care of anyone!

 

So, we decided that I would delay any procedure for myself because Tim had been suffering with his knee issue for a year.  (In retrospect, maybe not the best plan, for a number of reasons.) So, I scheduled two months of physical therapy to see how much recovery I could achieve. Tim had his surgery August 7th. He came home from the hospital on the 9th and I have been hobbling around caring for him ever since.

 

In the first month of PT, I made good progress with my knee. I could ice it 3-4 sessions a day, do my PT exercises, rest, and not walk on it too much. But once Tim had his surgery and I was caring for him full time, all the progress I made went out the window. The amount of walking, standing, stair climbing, cooking, and step-and-fetch-it care I did reversed any progress my knee had made. The consistent level of pain I have when I walk now has informed my decision to get surgery for my left knee. It won't be nearly as invasive or, I hope, as long a recovery as what Tim has endured. I have no idea when the surgeon will have an opening or when Tim’s going to be recovered enough to care for me, his business, the dogs, and the house.

 

What was so easy in our thirties seems like a mountain to climb now!

 

What does all of this have to do with my HRT journey? Well right in the middle of all of this enormous physical and mental stress, on August 9th I began to have breakthrough bleeding.

Which mean that I was spotting blood, due to the HRT. The first time I’ve bled in 15 years. I had no discomfort, just spotting.

Of course, when you first start hormone therapy you have to contact your physician if you are spotting. It’s not unusual at first. My naturopathic Dr. is so supportive. She listened to all of the stress that I was experiencing, my worries, how I was dealing with the pain I was in, while I was trying to keep our ship afloat. She really felt that the enormous stress I was under was causing high levels of cortisol which affected the available progesterone in my system, which is the part of the hormone therapy that protects the uterus and prevents bleeding.

She checked in on me every few days and adjusted the HRT dosage and we are now back on track with no more breakthrough bleeding.

Because of the nature of the high stress and physical pain I've been dealing with, it’s hard for me to make any kind of an assessment as to progress or changes I may or may not have experienced due to the hormone therapy.

I started my hormone therapy journey on May 24th. So, I am exactly at the three-month mark, which is where, if I wasn't currently living under such challenging circumstances, I’d be able to give you a better assessment of how I'm feeling about the HRT.

My next appointment with my orthopedic doctor is tomorrow August 28th— woo hoo— where we’ll be discussing my options for surgery. I'm not sure when he’ll have time in his schedule, and I'm not sure of the details about how long or hard the recovery will be, though I know it will not be anywhere nearly as extensive as what Tim is going through. I will know more tomorrow.

 

It feels like July and August have passed me by; I have not been to the beach once this summer and the beach is my jam! But, I am looking forward to the fall and getting back to walking the dog, going to the gym, and definitely not taking walking for granted!

 

I'm very grateful for our Medicare coverage. We have covered our annual deductible, so my surgery and Tim’s surgery are fully covered. I’m also very grateful to my daughter Morgan for how much she has helped us during the past two months. It would have been so much harder without her

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Drop me an email and let me know how you’re doing! Of course, I’m still seeing private clients, I have three openings if you are interested.  You can book a free consult  at the Book Online tab on the home page. And, the new fall schedule for The Sacred Circles of Change group coaching class is live and registration is open.  You can find out the details under the Class tab on the Home page.

 

Namasté,

Dr. A.

P.S. If you haven’t seen it, I’ve added a page under the Offerings tab called Access MedicalStudies.  Here you can download many recent medical studies on women’s health.

 

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