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Blog Posts (16)
- ADHD and Menopause, Is There a Connection?
I know. As if we need one more symptom or issue to worry about at this stage of life. Am I right? The good news is that NO - there is no connection. Well, not exactly. But. According to CHADD.org (Children and Adults with Attention-Deficit/Hyperactivity Disorder), there is a severe gender gap that leaves girls and women under-treated, under-diagnosed, and often misdiagnosed: Girls frequently display inattentive symptoms, including forgetfulness, trouble paying attention, and problems with organization. Boys tend to display hyperactive/impulsive symptoms, like blurting out or being unable to sit still in class. These hyperactive/impulsive symptoms get noticed more easily by parents and teachers while inattentive symptoms sometimes get ignored. Girls are also less likely to be diagnosed earlier because they often display more symptoms of anxiety. Medical providers may only treat a female patient’s anxiety or depression without evaluating for ADHD. Hormones, which affect the symptoms of both ADHD and anxiety, can complicate things. ADHD was never something that EVER crossed my mind. Not until I was put on a low dose (150mg) of Wellbutrin to treat low libido. If you listen to Circling the Drain podcast, you know that Ellie and I have been on an experimental journey looking for low-libido solutions, and this was part of that experiment. While it didn't help with my libido, it did help with my focus. I was shocked. "Is this how I'm supposed to feel? Are most people this focused?" I thought. It turns out Wellbutrin is prescribed off-label for both low-libido and ADHD. Until then, I thought much of my behavior was perfectly normal. I have an A-type personality and consider myself a person who gets sh*t done; how could I possibly have ADHD? I've worked as a C-suite executive assistant for over 13 years in the high-stress, high-demand world of real estate development. If I didn't have my shit together, I'd fall on my face, right? Maybe. It wasn't until a friend recommended KC Davis' podcast Struggle Care, episode 31: Wait. Am I ADHD? with Dr. Sasha Hamdani, I realized I might be wrong about EVERYTHING. Do you ever listen to a podcast or read a book where you feel like someone is speaking directly to you? It turns out my ability to hyperfocus is probably what has kept me employed all of these years. All people experience hyperfocus in some way or another. You might call it being in the zone. However, when you have ADHD, it's either hyperfocus or NO focus. Women are VERY good at getting by and creating workarounds to cope with ADHD. Are we really surprised? We've been coping our whole lives. As I said, girls are often undiagnosed because their symptoms are not as apparent as with boys. For example, a boy might have outbursts of hyperactivity, but a girl might be hyper-talkative and easily distracted. Boys may openly fidget, while girls (taught to keep to themselves) may bite nails, pick cuticles or sometimes describe "internal hyperactivity." I think you can imagine what that is. Also, this trapped energy might manifest as a tic. More on all of that here. That was my story. I used to go through bouts of blinking uncontrollably. My mother's solution was to take me to the eye doctor, who (of course) said there was nothing wrong. I mean, it was the 80s. This habit went on for years, and I still want to do it occasionally (my husband has caught me), but as an adult, I have more control over my body, so I'm more aware. What does all of this have to do with peri/menopause? ADHD can be exacerbated by hormone fluctuations and everything else that comes with this time in life! More on that here. You might have gone your entire existence thus far without knowing you had ADHD, normalizing some minor, strange behaviors until something happens that forces you to pay attention. Like when I missed three different podcast recording appointments because of something called time blindness. I went from asking myself, "Is it me or is it perimenopause?" to "Is it me, perimenopause, or ADHD?" Indeed, many symptoms of peri/menopause are also symptoms of ADHD. For example, forgetfulness, depression, anxiety, and irritability, overlap, making it hard to tease out what is what. Some less common symptoms here: Being easily distracted Frequently failing to complete tasks, work, or chores Making careless mistakes Easily losing items Forgetting to do necessary tasks Having difficulty making plans Feeling easily overwhelmed by tasks or projects Inability to commit to a decision Difficulty with time management If any of that resonated with you, I'd suggest starting with the podcast episode I listed earlier. If it makes you feel seen, you might want to schedule an appointment with a therapist who can evaluate you and ultimately refer you to a psychotherapist for further help. I'm meeting with a specialist this week and will keep you all posted!
- ACL Surgery Recovery - 1 Month Update!
It's been a month, and it hasn't been easy, but I finally feel I'm seeing real progress. The mental toll that this has taken was unexpected. I had a pretty good attitude about it for the first couple of weeks, but as the third week pressed on, I found my mood was taking a turn, perhaps because it was sinking in that this would be months of recovery and not just a few weeks. However, in week four, I turned a bit of a corner. Here is what I learned! It's important to note that I began physical therapy on the 7th day of post-op, and I have been going steadily three times a week but doing my exercises every day at home. WEEK 2: I was pretty sick of laying about on the couch and was thrilled that my physical therapist cleared me for modified exercise. Up until this point, I had been weight training twice a week for YEARS and on week 2 was able to resume -- again with modifications and with my leg braced. Week 2 also brought a false sense of stability in my knee, to the extent that I was hobbling around a bit without my brace (not recommended). This is because all of that soft tissue is very stiff due to surgery, and stiffness feels like stability, but it's not. I slept well and figured out how to carefully side-sleep with my leg propped on a pillow. My PT put me on the stationary bike, where I was peddling backward and forward in half circles. I couldn't make complete rotations because I could only bend my knee to about 40 degrees or so. This is because of the quadricep graft, and I still had quite a bit of swelling. If you had a patella graft, you'd likely achieve full 90-degree flexion at this point. Keeping my knee wrapped in an ace bandage eventually helped bring the swelling down (in addition to icing regularly). By the end of week two, I was getting around my house and other controlled environments without my crutches. I also had my stitches removed and was trying to carefully remove dried blood with a warm washcloth but gave up at a certain point. "It will come off eventually!" I figured. If this is your experience, whatever you do, DON'T pick the dried blood or scabs! I know. Ewe! WEEK 3: I stopped using crutches outside, and I also started driving because, luckily, I injured my left knee and not my right. I was only going to and from physical therapy, so there wasn't much risk. As the soft tissue around the knee begins to mobilize, it brings back instability because the muscle becomes supple. This was when I ensured I had my brace on whenever I wasn't sitting. Most importantly, I realized that for two weeks I hadn't been really activating my quad fully. With some helpful feedback from my PT, I finally connected to the area where they had taken the graft and was able to do (what I would call) a lift of the muscle above my knee. Additionally, because the graft is very tight (it's meant to be that way so that you can eventually stretch it), we found that my femur and tibia heads weren't articulating correctly in the joint. I had to work to push the femur back into place by laying an ankle weight on my quad for about 5 minutes a day. Otherwise, there was a feeling of my knee catching every time I'd go to bend it. That said, I achieved 90-degree flexion by the end of week 3. WEEK 4: I turned a corner. I accomplished a pretty normal gait getting up and down the stairs. I'm making complete rotations on the bike, but what feels like a real win is that I'm getting much closer to a normal heel-to-toe gait while walking - instead of kinda limping around. At this point, I just want to walk normally! I also returned to walking my dogs, but only once daily. I'm slow, but they don't seem to care, and I certainly don't. I've been able to dress a bit easier, especially when getting pants and shoes on. I find I can't have my knee bent for too long or straight for too long, so I'm back to having issues when I sleep, BUT --all in all, a little bit of normalcy has returned. MAJOR TAKEAWAYS: PT (especially in the first three weeks) is physically draining but also mentally taxing. Listening to your therapist and your body and working through pain is exhausting. With that, I'd recommend scheduling your sessions at the end of the day because (at least for me) I just wanted to crash after. However, when doing your exercises on days when you're not seeing your physical therapist, I think it's more helpful to do them in the morning to get your knee warmed up for the day ahead. Also, if you still have a lot of pain at night and need to pop a Percocet, you're probably overdoing it. I learned this the hard way; trust me, it's not worth it. However, Motrin with Tylenol has become my best friend, and you might want to consider picking some up. Back to the mentally taxing part, it's nice to talk to someone who has been through this specifically or something similar (knee or shoulder surgery) because it's really hard, and many folks don't get it. It's difficult not to get depressed, but talking to someone who understands is helpful. That being said, give yourself grace if you're not up to socializing or talking to folks. All of these things are okay. Most importantly, remember this is not forever; it's just for now. It's a marathon, and slow and steady wins the race. But also. It's not a race. Lastly, I am VERY grateful I've been weight training for years. I don't know how I might have gotten around without my quads and triceps strength, especially in the early days after surgery. I thank my lucky stars for my dear friend and personal trainer Cheri Page Fogleman. Being able to continue my workouts, despite my limitations has kept me SANE. **She also has beginner group classes over zoom and is great with modifications. If you're interested, you can learn more about her here. ** 4- 10 WEEK GOALS: This is the stage when you will start to see a significant amount of improvement. Although the repair is still healing, it is important to progress the activity gradually and under the supervision of your physical therapist. Your physical therapist will ensure you are walking normally with proper alignment. Normalizing your walking pattern early in the recovery process is important. You may need to use an assistive device, such as crutches or a brace, to help you walk without compensation. You’ll continue to have manual therapy as well as an exercise-based treatment program. The ACL graft tissue continues to heal and goes through a remodeling process, which is WILD to me. It structurally becomes ligament tissue. Truly amazing, but this is important because a ligament is what you need to get that knee moving again. Not a grafted tendon. Lastly (fingers crossed), during this time period, you should transition to walking without assistance. Inflammation should be low, so you should start to see your mobility improve substantially.
- Menopause and Weight Gain - Is There a Connection?
I read Today's Dietician regularly. While I am not a dietician or nutritionist (nor do I pretend to be - I coach behavior change), I look to this publication for relevant information for myself and my clients. Their latest issue, "Injury Prevention & Recovery," obviously caught my eye because (HELLO) I'm in the deep, dark stage of early ACL surgery recovery. It did not disappoint. I learned all sorts of relevant information I'll be blogging about next week when I hit my one-month recovery milestone. But I digress. It did disappoint in its Ask the Expert section about Menopause and Nutrition. Firstly. They didn't ask an expert. They asked a nutritionist who has published many cookbooks and has often contributed to their publication but doesn't appear to have specific experience with treating menopausal clients. I'm sure she is an excellent professional and provides outstanding care -- I really don't want to sh*t on this person -- but when asked the question, "Does menopause cause weight gain?" This is what she said: It's not body changes during perimenopause and menopause that lead to weight gain, but rather lifestyle changes that happen during this time. "...many women may be less physically active at this time of life, as their kids leave home and there's less running around to do." In addition, women may be eating out more often because they don't have to feed a family every night. I'll just let that sink in for a moment. I won't comment why it's offensive and annoying because you already know why. First off. It's true. TECHNICALLY menopause does not "cause" weight gain, as referenced here on the North American Menopause Society (NAMS) website. And yes, it is linked to lifestyle changes but also a slowing of metabolism that comes with aging. So. Here is my question, and if you're a specialist-type-person reading this and have the answer, I'd like to know: since menopause and aging (typically) happen concurrently, how can you say that one has nothing to do with the other and why does it f*cking matter -- either way, it's happening!! Speaking from personal experience, I started battling weight gain (and a shift in body composition which I'll talk about here later) around 40. I am a child-free-by-choice human with a husband who has always done most of the cooking. I am and have always been a very active person doing Pilates, yoga, and cardio, and since I have lived in or commuted to New York City since 2005, I walk A LOT. Also - I've always been a "healthy" eater. When 40 rolled in, nothing had changed but my age and (in hindsight) a shift in hormones, but the number on the scale kept going up. So, please. Tell me and thousands of other women with the same story that perimenopause or menopause has nothing to do with weight gain. Now, to backtrack a little bit here - I do want to say that often "weight gain" gets conflated with a difference in the "distribution" of fat or a difference in body "composition." I say this because while people haven't put on pounds, they might have more visceral body fat, specifically around the belly and inner thighs. NAMS agrees that a shift in fat distribution is a thing due to a drop in estrogen. So. A client may complain that they are "getting fat" or "gaining weight" when in fact, they're experiencing a shift in body composition. However, some folks like me actually gained weight without any lifestyle change, for f*cks sake, so let's stop gaslighting people! I'm sure these changes might be due to empty nests, but let's not forget that most women reach the HEIGHT of their careers in their 40s and are killing themselves with cardio, dieting, and everything else to keep fulfilling their obligations, so it's probably elevated cortisol! Not to mention that more and more women aren't having kids or ARE having kids later in life and might be getting pregnant during perimenopause and raising children into menopause! Feel free to unpack that mindf*ck at your leisure. My point? There is a bigger picture here. The body you had in your 20s is not the one you have in your 40s, which is not the one you'll have in your 60s. Each evolution of your body has different nutritional and physical requirements to keep that meat sack ticking along. In fact, from age 30, muscle mass decreases by around 3% to 8% per decade. This decrease accelerates after 60—more on the connection between a reduction in body mass (sarcopenia) and aging at Pubmed here. What to do? Come to an understanding that what's been working for you for YEARS no longer works for you now, and that is okay because it's NORMAL. So what does work? Whelp. Every body is different, so be prepared to experiment, but we know that eating enough protein is essential because the aging process tends to reduce the quantity and quality of our muscle mass (free protein calculator here). We also know that if you're not already doing some resistance training - whether it's Pilates or weight lifting or a combo of both, you need to get started with this YESTERDAY. What else? Sugar, gluten, dairy, and alcohol might be things you need to eliminate or dial back, among other inflammatory foods. Furthermore, if you are a mid-life trans woman or trans man (I cannot stress this enough), working with a dietician well-versed in trans-care would be wise. This person can help you meet your changing nutritional needs while receiving gender-affirming care. We all need strong muscles and bones! If you have the means, it's a great time to start building a team of healthcare professionals to support you, which might include an educated gynecologist or functional medicine doc that can prescribe the gold standard care of MHT (menopause hormone therapy - for cisgender women), a personal trainer, a dietician and you guessed it - a health coach like me. In conclusion, I'm not interested in whether menopause directly affects weight gain, nor should you. Your experience is your experience, and it deserves validation. The cause is not important. What is important is what you do next. Think of it as a pivot in lifestyle. Coincidentally, our latest interview on Circling the Drain Podcast with Dr. Vonda Right is a goldmine of information on this subject. If she doesn't inspire you, something is seriously wrong with you. You can listen here if you like. Preserve the body now so that you can prevail as you age!
Other Pages (9)
- Perimenopause | My Site
Acerca de What the heck is Perimenopause? Fast Facts If you were born with ovaries, menopause is unavoidable. Menopause itself is a retrospective diagnosis, given when you have not menstruated for 365 days. Perimenopause is the time leading up to that point and is typically when you become symptomatic. It can start as early as your 30’s and can last anywhere from 4 months to 14 years. You read that correctly, FOURTEEN YEARS! If you are experiencing things like irregular periods, sleep disruption, increased anxiety, changes in libido, mood swings and more, chances are, YOU ARE IN IT. If your doctor hasn’t helped you, or worse, has dismissed you, you've come to the right place! We will find the right tools for navigating this mid-life f*ckery, together! VALIDATE The f*ckery is real. These symptoms are not in your head, and you are not alone. Let’s talk about it! EDUCATE I provide relevant, science-based facts, information, and resources to further your knowledge around your experience so that you can decide what the best approach is for YOU. ADVOCATE Doctors receive very little training around menopause, let alone perimenopause. However, there are proactive ways to approach your medical care. Together, we strategize the best way to communicate with your medical provider and others in order to receive the care and attention you deserve. POWER You are the expert on your own body. Being able to speak intelligently and confidently about your present health and concerns creates sovereignty. My Approach Take Action!
- Perimenopause Health Coach | Julia G Wellness
Circle Perimenopause Menopause Burnout Hormones Weight Loss firstname.lastname@example.org ENTER
- About | My Site
The Full Story How Did I Get Here? On an evening in March of 2020, I had just gotten home from working an 11-hour day at my corporate real estate job. I bent down to get something out of the kitchen cabinet, hit my head and burst into tears. It didn’t even hurt. Not really. Dramatic, right? Maybe. The truth was I was burnt out. My sleep was a disaster, I was overweight and fatigued all of the time despite the fact that I was working out consistently and eating right. I couldn’t figure out what was going on! I felt alone and totally out of control of my body. I looked at my husband and said, “I’m done, I need a time-out so I can figure out what the heck I’m doing. I can’t keep this up anymore.” One week later, our office shut down due to the pandemic and the decision was made that we were working from home indefinitely. Although not ideal circumstances, my time-out was handed to me. A month later I stood in the deli line at the grocery store, masked up and gloved up and I had my first hot flash. One year later, filled with total disgust and frustration at the lack of information and attention given to perimenopause and menopause, I started a podcast about the subject. A few months after that, I decided to go back to school and get my health coaching certification, along with finishing up my Pilates apparatus training. I hope that my experience and knowledge can help you on your journey with midlife change, body bedlam and burnout. Whether it’s as specific as weight loss or as nebulous as fatigue, I’m here to support you on your journey, whatever it might be! More About Me I am a graduate of the Institute for Integrative Nutrition with an emphasis on hormone health and a focus on perimenopause, menopause and burnout. I am also a graduate of the Kane School of Pilates. I received my Bachelor of Fine Arts from the University of Central Florida. I cohost the perimenopausal podcast, Circling the Drain : a show about the period before you stop getting your period. I am also a three time alumni of the switched up storytelling series, No You Tell It ! I studied meditation and philosophy at Philosophy Works in New York City, where I received my mantra for Transcendental Meditation in 2013. I have been an avid practitioner of both mindfulness and TM ever since. I always remind myself that my body is forever-changing, so it's important to remain flexible. What worked 2 years ago may not work today! I believe that even in our darkest moments, humor is everything. I believe that change is necessary and patience is essential. I believe power comes from resilience. Some things I'm very good at: starting several books at once and not finishing any of them, skipping steps in a recipe and pretending it tastes fine , and not sharing popcorn at the movies as I eat the ENTIRE tub.