Menopause

It’s all so quiet

The joy of being on holiday is guilt free daytime telly viewing.  I have watched all kinds of rubbish this week but one thing that caught my eye was on Lorraine Kelly’s show

‘Does your workplace offer any support for women going through menopause?’

Apparently Lorraine is running a series called the ‘M Word’. Now admittedly my original intention was to catch up on high street fashion but I was intrigued to see where the discussion would go.

I’ve shared my own experience in a couple of blogs but it’s something that I continue to learn about and hence want to write about.

So back to the question – I haven’t a clue but my feeling is no.  In the NHS if you are pregnant, had a needle stick injury or are stressed then yes, there is support and very good it is too.

However when I went to my local Occupational Health department a few years ago shortly after my diagnosis they didn’t seem to know quite what to do with me.  Now don’t get me wrong they were lovely and very sympathetic but that’s as far as it went.

‘Could we tie it into your migraines?  That would work as migraine is on our list?’

‘How would that help?  I’ve not had a migraine in ages’

‘You know they say that happens with the menopause so that’s good news!’

‘Right………Well, thanks for that. Bye!’

I didn’t really give it anymore thought until this week so I began looking around the internet to see if things had changed.

It’s worth noting that the NHS is 77% female and while the average age of menopause in the UK is 51 there is an increasing number of women under the age of 40 being diagnosed – 750,000. So it’s pretty common.

There are an array of symptoms associated with menopause but the one that stands out is mental health.  Many women are so debilitated with depression and anxiety that they’ve had to take time off work with some even leaving altogether.  What I found most shocking is that according to the 2014 Nuffield Health survey about a quarter of them thought their mental health problems were simply due to stress.

With that in mind I wonder how much our Occ Health colleagues ask about other menopausal symptoms in women referred with ‘stress’? Perhaps as it doesn’t fit neatly into a list I wouldn’t have thought it’s even considered.

What I have found over the past few years is a total lack of awareness never mind education or discussion.  Anything that has been done seems very stop, start.

Now I do admire those who are trying to break this cycle (pardon the pun).  Our nursing colleagues seem to have acknowledged it with the Royal College of Nursing and Midwives producing guidance.

Even the Police are taking it seriously – there’s a National Police Menopause Action group with a clearly defined processes and information for managers.

Despite all my searching I couldn’t find anything from the BMA or any other national guidance for that matter.  Last week I wrote about a workforce of ghosts and I’m reminded of this again when I think about all the women I encounter on a daily basis.

So on my return to work this week I plan to pop into my Occ Health department to ask them what our local guidance is. If we have none then I will be suggesting that one is developed or consideration given to organising some drop in sessions.

It would be nice to think that working women wouldn’t have to rely on daytime telly as their only resource. If so the only cycle that will continue is that of ignorance….

References:

https://www.nuffieldhealth.com/article/one-in-four-with-menopause-symptoms-concerned-about-ability-to-cope-with-life

https://www.rcn.org.uk/professional-development/publications/pub-005467

https://www.rcm.org.uk/sites/default/files/Equality%20and%20Diversity%20Publication%20-%20Working%20with%20the%20Menopause%2020pp%20A5_7.pdf

http://www.westmidspolfed.com/news/posts/?/Force-leads-the-way-with-menopause-awareness-training&utm_source=Magma&utm_medium=email&utm_campaign=Federation%20eZine:%20September%202016

https://www.unison.org.uk/content/uploads/2013/06/On-line-Catalogue204723.pdf

nhs

Día de los Muertos

My previous blog generated a fair bit of discussion around mental health and it’s something that’s still on my mind a couple of weeks later.

Since adopting (or at least trying to adopt) the 4 agreements the one I’m having the most success with is ‘take nothing personally’.  It really is quite liberating!  That said it still needs a degree of self awareness.  You can’t really blame someone else for projecting their reality on to you when in fact it’s you that’s being an arse in the first place.

It also doesn’t mean letting people away with behaving badly either. I’ve become much more aware of other people’s sense of personal responsibility for someone else’s bad mood or perceived injustice.

What I have been less good at is being ‘impeccable with my word’.  Man alive it’s hard!  It’s all good and well when everything is plodding along and you’re full of energy.  However after a day of constant paging, emails and bouncing from one thing to the next the only thing I’m impeccable with is my choice of expletives.

However it was with this fresh perspective that I went to our Consultant away day.  The day had been organised to bring together senior clinicians and management.  I’m not going to get into the detail of the day as the whole premise was to have a safe space to air views.  I would however like to make some observations based on the many away days I’ve been to over the years.

I am beginning to think that the NHS is being run by ghosts.  You know they’re there, you just can’t see or hear them.  Traditional thinking is that they are dead inside however judging by the comments made on post it notes or feedback sheets there is in fact spirit.  However that spirit is in pain, feeling frustrated and not being valued.

I always think the purpose of these days is to exorcise feelings in something akin to a purge. So is it merely enough just to write them down or stick them on a wall?

The reason I think many of these well intentioned days fail is precisely due to this.  It all gets written down and not followed through.  Many assumptions are made about whose fault it is and life goes on the same.  It’s all a bit depressing.

So why not try something different and call these days what they really are: ‘Day of the Dead’ and no, I’m not being facetious.

The Mexicans believe that the day celebrates the cyclical nature of life in particular how new life can come from death.  Why not in these team building, management away days openly talk about the past but with one major difference – let ideas and life evolve and flourish.

I know some of you will be thinking ‘but we do that’ however I’m here to tell you it’s the exact opposite that happens. Why else do we keep having the same conversations if things are moving forward?

What we need to do is restore a little faith and breath renewed life into our workforce. Acknowledge the past but not stagnate in it.

Let the spirit of our NHS live…..

nhs, Uncategorized

You Got the Love

When I started writing these blogs it was with the intention of starting some conversations and understanding different perspectives.  Most of all I wanted them to be authentic.

This week I gave serious thought to resigning.

A perfect storm of events last week lead me to sit down and try to put into words why.

As I read it back the following day it made for painful reading.  Most of the issues centred around everyone else and how I was reacting to their behaviours and attitudes.  There was very little about the actual job of being a doctor.  A job I love.

When I’m under severe stress or pressure I withdraw. I go into a mental bunker and stay there while my brain conducts a sort of mental purge.  All kinds of garbage can come spewing out.  Most of it is a series of imaginary conversations all of which are in fact rooted in reality.  Things I wished I’d said, what that person would’ve said if I had.  A whole lot of nonsense really.  However it’s this nonsense that depletes my energy and causes unnecessary friction.  It had also brought me to the conclusion that I no longer wanted to work as a doctor.

For those of you reading this who have never experienced it I genuinely admire you.  I do believe though that the vast majority are not so blessed.

My mental health is such that I can recognise the signs and choose to retreat.  I need to let my mind do it’s thing but at the same time try not to pay attention to it.

During these times I rely on practicing mindfulness (Headspace) so I can literally watch the thoughts float in and out my mind.  At the point I have to stop concentrating and ‘let my mind do whatever it wants to do’ I never cease to be amazed that it does nothing. Nadda.  No thoughts at all.  This amuses me no end given the constant chatter of it at any other time.

I also listen to podcasts. Shortly after listening to one such podcast I had something of an epiphany (or mini psychotic moment depending on your perspective).  I listened to an interview with Don Miguel Ruiz.  He wrote the book ‘The Four Agreements’.  I’m not one for airy fairy self help stuff but this book has made a significant impact on me.

The four agreements are simple:

1. Be impeccable with your word

2. Don’t take anything personally

3. Don’t make assumptions

4. Always do your best

Hearing him speak and then reading the book has really forced me to stop and take a proper hard look at my own perception of the world and how it’s so dependent on the opinions of others.  My preferred poison of choice – the one telling me I’m not really good enough.

What I have found in the space of a week is that like mindfulness, when you put a stop to the white noise you are left with something of a void.  I’m not sure what to make of it just yet other than it’s very quiet. If I’m being entirely honest the silence is taking some getting used to but it does feel good.

I also can’t say with certainty how it will ultimately impact not just my professional but also my personal life.  I do feel like there has been something of a seismic change in my outlook.  I also believe it stopped me from giving up on something I love.  And that can only be a good thing……