40 in forty: Get your annual exams and know your body

When I was a newlywed and thinking ahead to the childbearing years on my horizon, I began tracking my basal temperatures each morning. I can't remember why I first started doing so; maybe I already realized how irregular my periods were, or perhaps I just wanted to get my ducks in a row and a good friend who tracked her temps suggested I do the same as she'd had trouble ovulating and getting pregnant.

Armed with my basal thermometer, some print-out charts and the marvelous book, Taking Charge of Your Fertility, I soon found that I wasn't regularly ovulating; that would make getting pregnant difficult.

We were in Cambridge then, and, lucky to have the benefit of the fantastic Harvard medical system, I made an appointment to figure the ovulation thing out and found that I had a small cyst on my pineal gland and that I had a significantly under-active thyroid, an integral part of the endocrine system that regulates many important hormones, not least those linked to reproduction.

Because I found all of this out early on, I could 'take charge' and take care of my body. A few MRIs found that the pineal cyst was totally benign and had probably been there for ages. Basically, I can ignore that now. And hypothyroidism is easy to treat; you simply need to find the right dose of synthetic T4 (an identical replacement for what one's thyroid gland produces in non-hypothyroid folks) and take it daily. 

During the regular blood tests during my first pregnancy, I found that I have a naturally lower platelet count. That knowledge has enabled me to inform subsequent physicians about my platelets when my bloodwork comes back and they mention it as a possible issue.

After I had Jack (with no issues at all) and finished nursing, I resumed tracking because my menstrual cycles again seemed haywire. This time I found that I had a vastly protracted luteal phase, the latter part of menstruation, which makes sustaining a pregnancy a challenge. Because I knew this, when I became pregnant with Oliver, I was immediately put on progesterone. It made me awfully sick, but I had no troubles with the pregnancy so totally worth it.

Throughout all of this, I found that I became infinitely more aware of my body's rhythms and "personality." It is always very clear to me when something isn't quite right, and I know immediately when I need to get something investigated.

I've kept detailed records and histories which has made appointments and changes in my doctors over the years really easy to navigate. There aren't any real question marks, and I feel both empowered and totally aware of my health. 

The same is true for my children. For both self and dependents, I have found it essential to advocate. Doctors are rushed, many often want quick and easy answers, and some think they know me or my kids better than I do, even though that feeling is in many ways absurd. I'm the one who spends all my time with self and children, for pete's sakes. 

I am confident that my repeated insistence that Jack's regular fevers weren't the same virus on loop was what finally led to the discovery that he actually had PFAPA, a febrile disorder marked my regular bouts of high fever and swollen tonsils. It was a breeze to treat WHEN we knew what it was. Before that, he was missing a week of school every five weeks and sick as a dog during those absences; often he had fever-induced night terrors. Once we started him on the medicine, old-school cimetidine by the way (a basic stomach acid reducer that is super-safe for pretty much anyone to take), Jack was never sick again and finally outgrew the syndrome.

My plea to you is to get your annual exams, know your body and your history, write it all down, and advocate for yourself and your health.

  • See the dentist at least once a year. In the meantime, floss every day. Every day!
  • Get your annual physical without fail.
  • Ladies, get your annual or biannual gynecological exams. Ovarian cancer is a mean, stealthy beast that often slinks in without symptomology. HPV is about as common as the common cold and is linked to cervical cancer. Find out what you have, if you have something, and treat it!
  • Ladies, I also want you to take care of your breasts. Do self exams, get mammograms when you come of age.
  • Men, if you have a family history of prostate cancer or any symptoms suggested prostate trouble, get your prostate checked. Come on, guys! You also need annual physicals, and watch your blood pressure and cholesterol which are, according to a doctor friend of mine, the big issues for men in their 40s and 50s. Please see the comment from DrBabs below for helpful links!
  • You should also get an annual skin check and in the interim periods check your own skin and wear sunscreen daily. I am an insanely freckly person so it's especially important to be vigilant. I've had moles removed from my back and foot and have a great relationship with the irregularly-shaped and colored moles on my shoulders and chest. Skin cancer is not to be trifled with.
  • Do NOT ignore your mental health. Anxiety and depression are real and do not in any way mean you are weak. They can be treated and should be. Therapy is a gift and in my opinion should be something everyone does. We're all human, people, and even those who lucked out in the family department have shit to deal with.
  • Eat cleanly and exercise. I eat butter and olive oil and full fat cheese and a bit of dessert every single day. By eating cleanly, I mean Eat Real. Avoid processed shit, diet stuff, things with infinite shelf-lives, and too much sugar. 
    We all need regular exercise, but ladies, as we age, it is especially important that we do weight-bearing and balance exercises. We lose bone mass as we grow older, and weight-training and core strength will help us keep our bones strong AND avoid dangerous falls.

Most insurance covers all above-mentioned tests because they count as preventive care. 

It might seem scary to venture into unknown lands where you could discover something ugly. But I believe that it's better to know as early as possible so that any needed treatment can start pronto. 

Go forth, know yourself, love yourself, care for yourself. Encourage others to do the same!