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    The Menopause Lady: A Menopause Practitioner's Memoir of Life, Love, Breast Cancer, and Her Choice to Return to Estrogen.
    The Menopause Lady: A Menopause Practitioner's Memoir of Life, Love, Breast Cancer, and Her Choice to Return to Estrogen.
    The Menopause Lady: A Menopause Practitioner's Memoir of Life, Love, Breast Cancer, and Her Choice to Return to Estrogen.
    Ebook127 pages1 hour

    The Menopause Lady: A Menopause Practitioner's Memoir of Life, Love, Breast Cancer, and Her Choice to Return to Estrogen.

    By Nancy Siskowic

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    About this ebook

    This memoir is about life, love, facing breast cancer with its challenges and change. Nancy begins this story with segments from her life that helped form her into the woman she is today.

    As a nurse practitioner with a specialty in menopause for the past 25 years, she knew she was about to face a tumultuous battle. Blindsided by the diagnosis of breast cancer, she had turned to her journal for guidance and calm. Hormone therapy had been a lifeline to her health and sanity for many years, but now she had to reconcile with the thought of letting go of her estrogen patch.

    As she gradually reduced the size of the patch while awaiting surgery, symptoms she had experienced years before crept back with a vengeance - hot flashes, night sweats, insomnia, brain fog, irritability, mood swings. The incredible shifts overwhelmed her, she felt as if her life was falling apart. She could still help her patients, but unfortunately not help herself.

    Suddenly finding herself in a patient role, she knew she needed to speak up and to be heard. Thus began her process of research, seeking out and speaking with experts in the menopause field about hormones after breast cancer, daring to question medical professionals, and ultimately finding her voice. Finally, after doing her homework, journaling extensively and assuming personal responsibility for her future health, she returned to her beloved estrogen. It was not an easy path.
    LanguageEnglish
    PublisherThe Unapologetic Voice House LLC
    Release dateNov 24, 2020
    ISBN9781735974804
    The Menopause Lady: A Menopause Practitioner's Memoir of Life, Love, Breast Cancer, and Her Choice to Return to Estrogen.
    Author

    Nancy Siskowic

    At age fifty one Nancy Siskowic earned her Master’s Degree as a Psychiatric/Mental Health Nurse Practitioner, and two years later completed studies to become a Women’s Health Care Nurse Practitioner. For the past 27 years her primary work has been providing hormone consults to mid-life/menopausal women, as well as practicing as a psychotherapist. Her background includes being a Mind/Body Educator with the Deepak Chopra Center for Well Being, and possessing a Certificate in the Art of Spiritual Direction from Loyola Marymount University, CA. She has lectured extensively nationally and locally on menopause, was a guest on GMA’s 1996 menopause special, and on Lifetime Cable Chanel ‘New Attitudes’ special on peri-mesopause April 1999. Her article “Hot Flash! Hormonal Alchemy During the Menopause Transition” was published in PRESENCE, the International Journal of Spiritual Direction in December, 2008. In June 2017 she was diagnosed with breast cancer. That journey, plus her return to hormone therapy provides the stimulus for this memoir.

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      Book preview

      The Menopause Lady - Nancy Siskowic

      friend.

      Preface

      We all experience bumps in the road of life that we must navigate. One of mine was breast cancer. It created uncertainty and profound questioning, as I trust it would with most anyone.

      My hope in writing this memoir is to put my breast cancer experience and my journal notes to paper, in particular my emotions, both the tumultuous—trying to come to terms with cancer—and the hopeful—my broadened sense of hope. I also wanted to piece together some of the personal background information that I believe has helped shape me into the woman telling this story, as well as provide insight into the intense soul-searching that I underwent as a result of this journey.

      Menopause is arguably one of the more difficult life phases a woman must deal with. Since my own midlife, I have been privileged to educate women with the medical knowledge I have gleaned as a nurse practitioner with a specialty in menopause. The past almost thirty years of my life have been dedicated to education and to presenting the physical, psychological, relational, and spiritual aspects of midlife to those who come to me as patients. I listen to their struggles, address their fears and concerns—often about hormones—answer questions, prescribe hormone therapy, and quite literally pay forward what I have had the fortune of learning and living.

      With my diagnosis of breast cancer, estrogen deprivation negatively impacted my life. That incredible, problematic shift is a large part of my motivation for telling my story. The ramifications of that deprivation are sprinkled throughout the following pages.

      My desire is to be open and transparent. It was not an easy journey, but it has made me even more of an advocate for the important role estrogen plays in women’s lives and how it can change our lives for the better.

      With the crisis my diagnosis created, finding my voice became a real struggle. And so I was compelled to embrace my fears and concerns, to research the topic of hormones after breast cancer more thoroughly—a topic that seemed to be ignored by too many medical professionals—and to question experts in the field of menopause.

      Throughout my journey, my hope was always to be heard by my doctors. I wanted to be able to present my case about the role estrogen had played in my life, how the loss of my estrogen robbed me of so much. The change from the person I had been to the person I became was dramatic. I felt lost. It was as if I was only half a person. My suffering was intense and deep.

      After many tears and a great amount of soul-searching, I was able to embrace my own role and personal responsibility in my treatment plan, and I made the decision—with my husband’s support—to return to hormone therapy after my breast cancer treatment. I believe those struggles and moments of profound introspection and self-awareness triggered immense personal growth.

      I hope that my words may both reassure and encourage women to find that a diagnosis of cancer has the potential, in its own obscure way, to be a gift in our lives, a kind of spiritual awakening. I want to empower women to do their homework, to question, to thoroughly explore their situation, to search inward for their voice in the midst of this or any crisis they may face. Participation in our own lives and treatment choices, and finding the path best suited for us, is vital.

      I firmly believe there is still a knowledge void and too much misunderstanding surrounding the benefits of hormone therapy and its role in breast cancer among both women and practitioners in today’s world post-Women’s Health Initiative, a 2002 study I will discuss in this memoir.

      I owe a huge debt of gratitude to an expert in the menopause field, Dr. Philip Sarrel, professor emeritus at Yale University, whose vast knowledge of and personal involvement in menopause research has influenced me over the past many years. He has served to educate me, to act as a mentor, and to offer insight and direction—so much so that much of what I say about menopause owes itself to his wisdom.

      Chapter One

      OMG

      I found myself crying as I lay next to Ed one summer Sunday morning. We had made love, and our time together had been so beautiful. Moments later, the tears had come, the sobbing from deep within. The future felt stark. I had breast cancer, and I was being asked to abandon my hormone therapy, a treatment that had become an essential component of my identity, my sense of self, and my life over the past twenty-five years. I understood on a visceral level that what awaited me with my diagnosis several weeks prior not only contradicted the professional beliefs I had been cultivating for decades but was about to fundamentally alter my personal way of being—my body, mind, emotions, and sexuality.

      Twenty-five years ago, I was teaching Lamaze childbirth classes, as I had been for years. One day when I was attending a birth at the hospital, I commented to a fellow nurse how very warm it was. She laughed and announced that it wasn’t warm, it was just me having a hot flash! To say I was shocked is an understatement. I wasn’t expecting this for another couple of years. The hot flashes continued, day and night, to the extent that my sleep was impacted and my brain was in a fog. I was taking a statistics class that summer, too, and certain I would never pass it with all these symptoms. I resorted to taping every class and listening to them while getting ready in the morning, driving in my car, eating—anytime I could. I also visited my gynecologist, who confirmed my suspicion and placed me on estrogen and progesterone. Bingo, I felt like myself again. My brain even returned.

      At age forty-eight, having raised two children, gotten divorced, and worked as a school nurse, I pursued a career change and became a Nurse Practitioner (NP). My medical focus continued to evolve in my early years of practice as an NP, and I went on to become a Nationally Certified Menopause Practitioner (NCMP) with the North American Menopause Society (NAMS). My days were spent providing consultations to women going through midlife transition. The stories patients told were often similar—repeated tales of the loss of quality of life. Every day I’d hear descriptions of hot flashes, night sweats, brain fog, loss of libido, and weight gain, all caused by fluctuating, reduced, or absent estrogen.

      My response grew familiar as my years of practicing medicine continued. I listened to these women and provided up-to-date information to educate them and help combat their fear of hormones. In most cases, I wrote prescriptions for hormone therapy. Patient after patient told me this intervention had made them feel like themselves again, and this approach became my passion. Women deserved this.

      And then there I was on that summer morning in my husband’s arms, facing surgery in four days to treat my breast cancer. I was resigned to giving up my own estrogen patch, progesterone, and testosterone cream, the treatments that had become so important, so vital, to sustaining me in so many ways for almost thirty years. The consensus among my oncology team and other providers was clear: discontinue hormone therapy. The message, both implied by some and stated directly by others, was that the estrogen patch would hasten my death.

      It will kill you.

      How could I be so bold and reckless as to ignore their advice?

      That Sunday morning, I said to Ed through my tears, This beautiful part of our lives may be ending. It will undoubtedly be diminished.

      I was certain that without estrogen, the sexual relationship that was an important component of our lives together couldn’t continue to be as robust and enjoyable for us. Ed and I were having to confront the beginning of a potential major loss. I planned to heed the medical advice I’d been given. The fear I felt of the cancer growing inside my body was considerable, and I couldn’t deny that it was motivating. Yet, there was still this dueling fear, also motivating, of giving up my hormone therapy. What would these two realities mean for me when it came to my mind, my wellness, my prognosis, and my relationship with Ed?

      As a health-care provider and menopause specialist, I have educated audiences and published my recommendation that hormone replacement therapy be given strong consideration to support overall wellness in perimenopausal and postmenopausal women. There are numerous impacts of depleted estrogen, affecting everything from body mass to cardiovascular health. And importantly, as Ed and I understood, sexual health also often suffers. We were painfully aware of the impact of hormone loss on a woman’s libido and overall sexual response. In my career, I had observed that sexual complaints peak around menopause. Women find themselves blindsided by the physical, emotional, and sexual shifts in their bodies brought on by fluctuating and diminishing estrogen and lessened testosterone. And worse yet, these symptoms don’t improve with time. Instead, they sometimes get worse.

      I also knew from listening to patients for years that physical and mental health are often closely tied together. Beset with the many physical symptoms of estrogen loss, a woman’s close relationships can easily suffer. Intimacy behaviors may get lost or tossed aside. Expressions of affection that can be taken for granted in earlier phases of life—those gentle touches, spontaneous

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