Coping with the perimenopause when you’re a carer

This week on the podcast, Dr Louise is joined by Tova Gillespie, a working single parent to two daughters, one of whom has severe disabilities and complex medical needs. Here she talks about the challenges of being perimenopausal while being a carer and how it’s easy to not recognise or understand your symptoms.

Louise and Tova discuss how it’s easy for your own needs to end up at the bottom of the to-do list when you’re a carer or have a busy family life, and Tova shares three tips for anyone who may not be looking after themselves:

1. Learn to ask for and accept help. People want to help, but very often they don’t know how to offer it and our usual response can be ‘no, I don’t need anything’. Instead, say straight out: ‘Please do my washing up. Or I have five loads of clean laundry that needs sorting. Or can you bring over some food?’ Anything really.
2. If your health isn’t what it should be, go to your GP. When you ring your GP, ask for an appointment to talk about perimenopause and hormones. They’ll know from the get go what it is you’re after and if they have anyone in the clinic with an interest in that area, they’ll put you in with that person.
3. Try to see the good every day. I do gratitude journalling, where I write down a minimum of three positive things that have happened that day, and they’re not big. It could be the sun is shining. It could be the taste of that first sip of coffee in the morning. I train myself to look for the positive because it’s so easy to get overwhelmed in the bad stuff.

Learn more about Tova on her YouTube channel. Or follow her on Instagram @parentXP

Click here to find out more about Newson Health.

Transcript

Transcript:

Dr Louise: [00:00:11] Hello, I’m Doctor Louise Newson, I’m a GP and menopause specialist, and I’m also the founder of the Newson Health Menopause and Wellbeing Centre here in Stratford-upon-Avon. I’m also the founder of the free balance app. Each week on my podcast, join me and my special guests where we discuss all things perimenopause and menopause. We talk about the latest research, bust myths on menopause symptoms and treatments, and often share moving and always inspirational personal stories. This podcast is brought to you by the Newson Health Group, which has clinics across the UK dedicated to providing individualised perimenopause and menopause care for all women. So today on the podcast we’re going to talk a bit more inclusively actually, because there’s lots of women we know that are struggling, but also as women, we often put ourselves right at the bottom because we’re too busy, often looking after others, concentrating on various things in our life. And so I’ve got someone with me today, Tova, who has been really inspirational. Hopefully after this podcast, many of you will follow her on YouTube and see how incredible she is. She’s got a really interesting but not unique story, and I want her to really share it with us and talk about how hard it can be, when really it’s impossible for us to concentrate on ourselves in the way that we should. So thank you so much for coming on to the podcast today. It’s great having you here. [00:01:46][95.9]

Tova: [00:01:47] Thank you so much for inviting me to be with you today. It’s really fantastic to be here. [00:01:51][3.9]

Dr Louise: [00:01:52] So do you mind telling me about what’s been happening to you over the last, well, since your oldest daughter was born really? How your life changed? [00:02:00][8.3]

Tova: [00:02:01] Yeah, absolutely. So I had children quite late in my life. I was 36 when I had my oldest daughter. And I went through a pregnancy that, from the baby’s point of view, was perfectly healthy and it was a highly monitored pregnancy because I live with a thyroid condition, so it feels like I had a million ultrasounds throughout to make sure that everything was fine with the baby. Then at the very end of the pregnancy, the baby stopped moving. I went into hospital to find out what was going on, and eventually she was born through an emergency C-section with something called meconium aspiration, which is when the baby’s open her bowels inside and inhale that, which can be extremely dangerous. In Elin’s case, this resulted in over ten minutes of no oxygen, and she suffered severe oxygen deprivation, injuries on her brain and all the other organs of her body. And all these other organs, they heal. But the brain unfortunately doesn’t. Once the brain cell is gone, it’s gone. And she now has brain damage. She has quadriplegic cerebral palsy, which means that she has very little to no control over any part of her body. She has very severe learning delays. She is non-verbal. She is non-mobile. Obviously she’s a wheelchair user full time. She has a lot of health issues. She has a feeding tube. It is not safe to feed her orally. And she has, quite complex epilepsy seizure disorder that lands her in hospital several times a year with medicine-resistant cluster seizures. So we try to record this a couple of days ago, Louise and I, and I was I was still in hospital then, and unfortunately, the NHS Wi-Fi wasn’t quite up to scratch. Yeah. So I’ve literally just come home from hospital after my daughter had to be taken in by an ambulance with medicine-resistant seizures. [00:03:57][115.9]

Dr Louise: [00:03:58] And you’ve got another daughter as well, haven’t you? [00:04:00][2.3]

Tova: [00:04:01] Yes. So my oldest daughter is ten, and then I also have a seven year old. [00:04:04][3.5]

Dr Louise: [00:04:04] So very, very busy at home. And most of us can’t imagine what it must be like because many of us, including myself, have children. But children with special needs and physical, mental, any disability, can be incredibly difficult. And I know when my middle daughter had sepsis and was in hospital for many days and took a long time to recover, you just forget about yourself because you’re only as happy as your least happy child. But when your children are ill, you just want to take that pain. You want to do everything you can. It’s a very weird thing until you’ve had children yourself, how you feel. But the last thing you think about is yourself. And so I can’t actually imagine, I can try and imagine, but I can’t imagine what it’s like living with a daughter that has a illness that is changing all the time as well, that you’re totally there, totally devoted to, and you have another daughter as well. So support is really difficult. And I’ve spoken on this podcast many, many, many times before, and I will do again, about the physical and psychological impact of perimenopause and menopause and how often we don’t know it’s happening. It’s not often actually until we have treatment, we realise how bad we’ve got. But tell me about your story, because obviously you’re here to talk about the perimenopause or menopause otherwise I wouldn’t have invited you. [00:05:28][84.1]

Tova: [00:05:30] Yeah, absolutely. And I think, you know, I’m just going to very quickly touch on what you said here, that it’s so easy to forget about yourself when you are busy caring for another. And that’s not exclusive to special needs parents, anybody who a lot of people care for partners or spouses or they care for elderly parents. But also even if you just have kids, as you said, and I’ve got a cat tail right in my face here. This is my emotional support cat. But, you know, I have somebody in my life who I have to be there for. She has to come first because if I don’t put her before anything else, it is dangerous. And if I spend well, when I spend so much caring for her that there’s no space left to care for me. And my perimenopause story is very much one of hindsight, which I’m sure a lot of you who are watching or listening to this recognise that it’s not until afterwards you go, oh, hang on. So I well, we all remember that fantastic year when Covid came and lockdown hit and my marriage did not survive lockdown, which I was rather expecting. So a few years ago I left my husband. I found a place to move into, and I was made redundant in a time span of six weeks. [00:06:47][77.2]

Dr Louise: [00:06:48] Oh gosh. [00:06:48][0.3]

Tova: [00:06:49] Because I’ve don’t do things by halves. And in the aftermath of that, I burnt out. I went into a deep burnout, depression, very severe anxiety. I completely lost my energy and my mojo. I was in survival mode. I was looking after my kids and that was it. And then I sort of slowly recovered from that. But I never recovered from the anxiety. I had other symptoms too. And if I give you a little list of symptoms, I’m sure you’ll recognise this. We have things like anxiety, fatigue, joint and muscle ache, irritability, brain fog, and all of these are very common symptoms of being a special needs parent. And they’re also very common symptoms of perimenopause and menopause. And I also had night sweats. And I think the night sweats were the only thing I could not explain away. Through other things. But everything else was, well, of course my muscles hurt I have a child who requires 100% manual handling. Of course I’m anxious. I’m a single, working, busy, special needs mum. Of course I’m irritable. I’m stretched way too thin. You know, all of these things. And I kept telling myself that I had these reasons to feel the way I was feeling. But really, it was the irritability that was the final sort of, no, hang on a second there’s more to it here. I dropped a bottle of vinegar and it smashed and it smashed spectacularly. I had glass splinter and balsamic vinegar in three rooms. That should not be possible. And I just stood there and I screamed every swear word I know in both English and Swedish. And my oldest daughter, she jumped at every shout. And my youngest daughter, she slowly backed out of the room and it suddenly just dawned on me. This can’t continue. I need help. So from there I booked a GP appointment and I called up my GP surgery and I said, I want to talk to somebody about perimenopause. And the receptionist said, I’m going to book you in with one of our women’s health specialists. And I got an appointment within a week. I came in to see a doctor. I explained how I was feeling and what I wanted and she went, we’ll get you onto HRT straight away. [00:09:08][138.3]

Dr Louise: [00:09:08] Amazing. [00:09:08][0.0]

Tova: [00:09:09] Yeah, really good experience. And, I know I’ve heard from your podcast, I’ve heard so many times that women are struggling to find doctors to listen to them, or struggling to find doctors who know about this. And I’m with a GP surgery that has no less than three women’s health specialists on the staff. [00:09:25][16.0]

Dr Louise: [00:09:25] So brilliant. And I do think things are changing. You know, I see the tip of the iceberg. I see people who are really struggling. But I know because I know a lot of GPs who are absolutely brilliant and find like I do menopause care so rewarding. And the earlier we can start people on HRT, the less they’re suffering. And it is interesting because it can be so easy to misdiagnose as depression or anxiety or like you say, even burnout. But when we actually ask the right questions and that’s all it is in medicine, is asking the right questions often and thinking about the right questions to ask because you don’t know what you don’t know. So you can’t ask questions if you don’t know what you’re asking them for. But actually, and I wish I could go back in time as a GP and a hospital doctor, because anybody who’s having any psychological symptoms, like you say, the low mood, the anxiety, the fatigue, we always need to be asking, are there any other physical symptoms such as the palpitations, the night sweats, the flushes, muscle and joint pains? And also, are there any changes? Are there any other reasons why this could happen? So, you know, you’ve been lifting your daughter for many years, so to suddenly get muscle and joint pains is a bit unusual, if you see what I mean. Having night sweats, of course, is a new symptom, and there are medical reasons why people can get night sweats. But the most common reason, of course, is changing hormones. But the other question that I also wish I had asked for many, many years is to women. Do you think any of this could be related to your hormones? And I think asking that because if you say, could it be related to your menopause? Often, myself included, would say, oh no, I’m not old enough for that. But which is rubbish, of course. But saying hormones does make us then think, oh yes, I have been a bit like this before my periods over the years, but it’s just been a day or two and I’ve not really thought about it. And it’s, I think so much for us as when I say us, I mean us as menopausal women or perimenopausal women. For us to join the dots to help the clinician because in ten minutes it’s very overwhelming having a short appointment and trying to get everything in. So that was amazing that your GP was so helpful in such a prompt way. [00:11:42][137.5]

Tova: [00:11:43] Yeah, I think I was very lucky as well. We have a fantastic charity here in Bedford where I live. Called Bedford and District Cerebral Palsy Society, and they support families with any complex needs, not just cerebral palsy. And they don’t just support our children, they support us parents. [00:12:01][17.8]

Dr Louise: [00:12:01] That’s wonderful isn’t it? [00:12:02][0.9]

Tova: [00:12:02] Yeah. And a few years ago, I cannot remember her name now, which is a real shame. But they invited a menopause specialists to do a presentation to us parents. And she came with a long list of symptoms and talked through what we might be experiencing and why it might happen and things that could happen. And I remember sitting there and that was sort of the first thing of, well I do have the night sweats and they don’t fit into, you know, symptoms of special needs parenting. And I thought maybe I am perimenopausal and then going, oh but I’m only 44. And it still took me a couple of years to actually go and seek help for it. [00:12:44][42.0]

Dr Louise: [00:12:45] And then did the HRT, has it made any difference at all do you think? [00:12:48][2.9]

Tova: [00:12:49] Has the HRT made any difference? It’s made an amazing difference. I started off on patches and the combined patches because one of my perimenopause symptoms was a very short but also very irregular period cycle. So my period was anything between 22 and 28 days, not the period, the cycle. So I never quite knew when it was going to come. And we were sort of talking, when do you start progesterone? And she went if you go on the combined patches, it takes all of the guesswork out of it. And so I went on the combined patches and it took two days and I felt improvement in my symptoms. And that was really amazing. I did three months on the combined patches, no two months on the combined patches, and then I changed and I went onto gel and progesterone tablets instead. I just didn’t get on with the patches. I found them very itchy and uncomfortable and I always felt them. And then when I swapped from patches to gel, my symptoms started coming back because somehow I seemed to be absorbing better from patches than from the gel. And my GP had already given me permission to play about as she said. She basically went, you can adjust your own dose. And so I increased. So I had two pumps. I increased to three pumps. My symptoms immediately improved. I have recently gone up to four pumps because over time symptoms have come back. But my anxiety is so much better. My irritability is much more manageable. The brain fog is I mean, the brain fog got to some not so funny and some kind of hilarious effects. In June last year, in the month of June alone, I lost my car keys between unlocking the car and sitting down in it six times. And now that’s funny, at the time is super frustrating. More dangerously, I forgot my daughter’s medicines. She’s on ten different medicines a day in different doses and different times to be giving. And I can’t forget that. And now I feel I actually have my brain with me. I can do things. [00:14:55][126.6]

Dr Louise: [00:14:55] So that’s really scary. We talk about the impact of menopause in the workplace, and often it’s with reference to changing temperature of rooms, which drives me crazy because it’s not just about flushes and sweats, as you know. And we talk about the impact of not remembering at work, but actually, I’ve been doing a lot of talking recently about the impact in the workplace and saying it’s not just at work, it’s at home as well. These women don’t change when they get home, but when you have someone who’s completely dependent on you, it’s really important. And I was talking to someone on Friday who’s suffering and is unable to get help from her GP, and she’s got a son with special needs, and she said her sister now comes over every day after school to look after him because she doesn’t trust herself, because she can’t remember things the same way. But she’s now worried because her sister is five years younger than her. So she said, what’s going to happen in four or five years time when she becomes perimenopausal? But actually, we shouldn’t be having to make these adjustments like that. This woman is desperate to try hormones and all she’s being given is antidepressants. But you know, if your daughter didn’t have her medication for a length of time, there are very difficult, hard consequences. And there’s, you know, you’ve already said you’re a single parent, so who’s going to remind you, who’s going to help you? [00:16:16][80.5]

Tova: [00:16:16] A seven-year-old child? I mean, my seven year old is amazing. But it’s also part of my responsibility to protect her from too much caring responsibilities too early because it’s not her job. It’s not her responsibility. [00:16:30][13.5]

Dr Louise: [00:16:31] So we forget this when people are thinking about the menopause. And I spend a lot of time thinking about the injustice to women and how or why people are refused an evidence based treatment that can really be transformational. And you look in history about the misogyny of women and it’s gone on and it’s going on for ages, but actually it’s a whole different level when it’s affecting others as well. There’s one thing being directly affected, and women can hopefully be advocates for themselves and work out what’s wrong and how they can get help, but it’s completely wrong on a different level when innocent people, especially children, are being affected by the menopause. And I know it happens a lot. And, you know, in a very small way, when I was experiencing symptoms, I was just so tired and irritable. I wasn’t really interested in cooking, so my children didn’t eat as well. I didn’t really want to play board games because I couldn’t remember how to do them, and I was, they always ended in tears because everyone was frustrated. So I ended up just switching on the telly and just go, oh go on just go and watch something. And the children obviously would love that. But my parenting was not great. But I’m very lucky. I’ve got a stable relationship, you know? I mean, a nice home that’s warm. I have three children that get on with each other. If I was a single mum of many children and had difficulties at home and then you throw the menopause in. We know that domestic abuse increases during the perimenopause and menopause. And when I first read about that, I couldn’t really understand why. And I do. And some of it is emotional abuse and it’s not intentional. It’s because we are just worn out and then we think it’s because we’re not good parents or, you know, we… And I certainly did I internalised this, I thought, well, I maybe I can’t be a working mum. Maybe having three children has broken me, whereas two was OK. And maybe it’s, you know, and you just don’t realise that it’s something that is reversible, that could, with treatment, really make a difference not just to you as an individual, but your whole family unit. [00:18:44][132.9]

Tova: [00:18:46] And I think HRT is so important. I mean just looking at the effect it’s had on me and how it’s regulated my entire body, I don’t feel I’m at 100%, I know I’m not at 100%. But compared to where I was and I said this to myself even when I started HRT, that if I can get back up to 60%. That to me is an enormous win. It really is. I mean, I full on hear what you’re saying there in terms of not having the energy to parent, not having the energy to cook. And of course I have to cook. Because, you know, there are two children here that have to be fed and I have to function. And so many times it’s just been to my youngest here are the headphones, here is the tablet. Because I don’t have more capacity or just curling up with both of them on the sofa and turning on the TV and just trying to hold it together and not break down in front of them because it’s not good for them. [00:19:46][59.5]

Dr Louise: [00:19:46] No. It’s so difficult because, you know, there is fatigue and there’s different types of fatigue, and many of us are tired. I mean, I’m quite often tired, especially in the evening. And I think, oh, have I got time to go through my emails or should I go to bed? And I’ll often push myself and go to bed a bit later. But actually the fatigue often of perimenopause and menopause, I used to think it’s a bit like drugs, you know, when you’re drunk. Not that I’ve ever been drunk, but I imagine. But also like when I was pregnant, the early stages, because it is a biochemical thing. And I kept saying to my husband, I just cannot stay awake. I feel like a zombie. It’s a very weird tiredness to explain if people haven’t had it. And it’s really like thinking through treacle. You can’t just think, right, I’ll have a coffee and I’ll keep going, or I’ll just go outside and get some fresh air and then I’ll be fine again. It’s a very crippling tiredness and with children it’s so unpredictable when they need you as well, that you can’t just have a nap in the day or go to bed a bit earlier. It doesn’t work like that when you’ve got children. [00:20:54][67.9]

Tova: [00:20:55] No it doesn’t, it doesn’t. And then if you add a complex needs child in the mix, it is getting up in the middle of the night because she’s had a seizure and she needs help, or she’s just had a muscle spasm and ended up in a position that she doesn’t like being in, and she can’t get herself back again to a position where she needs to be. And I mean, if we take this week as an example of just the broken or non-existent sleep you get. It was Tuesday evening, I took her into hospital, so we arrived in A&E around 8 pm. I went to bed the first time at 1 am, and then at 4 am she was having cluster seizures again and I was up for another hour before we had a medicine that worked. And then I got another three hours sleep and the parent beds in hospital they are not comfortable. [00:21:41][46.7]

Dr Louise: [00:21:42] No they’re not. [00:21:43][0.4]

Tova: [00:21:44] And you know, these are things that you just have to do. And of course, when I’m in the middle of it, I am the most capable person on the planet. I know exactly when the last seizure was, what the last medication was, what the history is, all of those things. You know, I’m standing in the middle of that room with an oxygen mask, a suction pump, and I’m directing the doctors as to what they need to do. And I’m the calmest woman ever. And then on Friday, when we came home from hospital, my brain trickled out of my ears and I could not function whatsoever for the rest of the day. [00:22:14][30.3]

Dr Louise: [00:22:15] Well, it’s very, very hard. It’s really difficult. And I think it’s amazing that there was a group where you could have support and information, because it’s often when others tell you, you get that lightbulb moment and I know, like just watching some of your YouTubes, you know, that’s what you’re trying to do with others. You’re, when I say normalise, nothing is normal. I realise that but and I would not want the conversation, the menopause, to be normalised so much that people think they have to cope with symptoms. But what you have done is you’ve normalised the treatment of the menopause. You know, when you’re talking about the treatment that you’re getting and what you’re doing and how it helps you in a, not a sensational way, just a matter of fact, it’s the same as cleaning your teeth. It’s just something that you’re doing to help improve how you are. And there’s a lot of demands on us anyway. But when we have children, especially children that are dependent on us, there’s a whole new dimension. Many of you might know my oldest daughter is registered disabled with chronic migraine, and when she’s well, it’s amazing. I don’t, you know, if I have a day without hearing from her it’s wonderful. But so many times she’s in despair and she can’t, you know, her speech goes, her coordination goes, you do this remote parenting. And so many times my husband and I have just got in the car or the train and gone to see her. And you don’t understand what it’s like to have someone completely dependent on you until it happens. And it’s so unpredictable. And that’s why you want to be as healthy as you can as a parent. Of course you always do. But if you’ve got someone who’s more dependent rather than less dependent on you, then you have to look after yourself. And that’s, you know, we don’t have a choice, unfortunately, because we can’t say to someone else like you can with a baby. Here you go, just look after her for the afternoon. It doesn’t work like that when you’ve got children with different disabilities and they need their mother. And you, like you say, you know your daughter inside out. It’s not the same as someone else taking her to a hospital or lying in that hospital bed next to her. So there is so much that we need to do to educate people. And the other thing before we finish really is thinking about cerebral palsy, thinking about physical and mental disabilities. Your daughter’s only ten. But, you know, give her another ten, 20, 30, 40 years. Who knows when her hormones are going to be changing in a negative way. And I recently did a presentation for people living with cerebral palsy. And it was really wonderful. I really enjoyed doing it. And the feedback was quite humbling, but huge because a lot of women said, oh, I’ve been told it’s my cerebral palsy that’s progressing. But it was only just before my periods I was getting more muscle spasms or unusual symptoms, and I knew it wasn’t quite because the women know their bodies as well. And there’s so much gaslighting going on generally in menopause and perimenopause. But I was really saddened to hear. And even at the end someone said to me, Dr Newson, you seem to be the first person I’ve ever met who really understands cerebral palsy. And I thought, gosh, I am not a cerebral palsy specialist, but I have a huge amount of experience in general medicine and empathy. And I’m also very, very open about saying the things I don’t know or don’t understand. But I would never make up a diagnosis to suit that patient because I don’t know what’s going on. And that’s often what happens in medicine when we don’t know what’s going on. We try and shoehorn people in to a diagnosis. So for these people being told, oh, it’s a progression of your cerebral palsy, it probably makes the doctor feel better because they’re saying something that they probably think is right. But if the patient is not agreeing or doesn’t think it doesn’t quite work, then it’s OK in medicine to say, I’m not sure what’s going on, but let me have a think and let me talk to other people. And in medicine, that’s what we’re doing all the time. We’re learning all the time. And ten years ago, I would never have been able to give any presentation because I didn’t understand the important role of hormones in our brains and our muscles and joints and our nervous system as well. But now I do, it’s really important to share that knowledge. And a lot of these women were really reassured, but also because they’ve got physical problems, many of them are being told they can’t have HRT because of the clot risk. Well, we know there isn’t a clot risk with the natural body, identical hormones with the oestrogen through the skin as a patch or gel. So just for them to know there are options for treatment. And as you know, anyone with any physical disability, especially when they’re not mobile, have an increased incidence of osteoporosis. So, you know, we’d need to be looking at future health of people with disabilities. And so it’s an area that’s really important, every area is important thinking about menopause and perimenopausal women. But this is really important. And I’m sure a lot of people with physical and mental disabilities will have an earlier menopause at a younger age, and if their behaviour is changing, they won’t necessarily know that it’s due to their hormones. And so it’s something else to be thinking about. For your daughter it’s in the future, but there are a lot of women out there now who are experiencing symptoms and not able to get treatment. [00:27:35][320.2]

Tova: [00:27:36] I mean, we’ve got puberty to look forward to with my daughter, and that thought terrifies me. And I think, you know, you’re, there’s so many people out there who have no idea just how much hormones work on the brain. And if you then have a brain with injuries on it, and this is what’s cerebral palsy is a type of brain damage. So you have a brain where the signals aren’t moving as they should do, the synapses aren’t firing as they should do, and then you’re adding a crazy hormonal cocktail to the mix. It’s not pretty puberty in these children, and I don’t personally know of women of perimenopausal age with cerebral palsy or with similar brain injuries. But I mean, if I’m looking at my brain that isn’t damaged and how massively it affected me, I can’t imagine how bad it is when when you have additional… [00:28:30][54.5]

Dr Louise: [00:28:30] It’s very interesting actually, because we know actually the first thing our brain does, if we have any injury is to actually produce more oestrogen, progesterone and testosterone. So these hormones are really powerful in our brain. They help improve the transmission of nerve impulse. They help build the myelin sheath, which is a conduction part of the outside of the nerves. They actually help the plasticity of the brain. So the way the brain develops and functions. And it would be amazing if people were doing some research in cerebral palsy looking at the benefits of oestradiol, progesterone and testosterone on the brain, because for so long we just think about them regulating periods or making moods worse. But actually, and for men too, men have oestrogen, progesterone and testosterone in their brains and produced in their brains. And so, you know, there’s a huge amount of work that should be done. And it’s not being done because HRT is very cheap. There’s no big pharma behind it. There’s no priority. It’s thought about just due to menopause. But, you know, we have got some data showing that there’s beneficial effects of hormones, especially progesterone and oestrogen in our brains. So there’s a lot we need to do to think about, you know, the hormonal benefits in brains of people who either have normal or abnormal brain function. So lots to do, lots to think about. But I hope this podcast has allowed people to really reflect and think again about perimenopause and menopause in different ways, and the potential impact it can have through other generations as well. So I’m really grateful for you sharing your story, because I know it’s always hard talking, and I know you’re so pragmatic and it’s not a sympathy vote because you’re just someone who just gets on and does things. But big respect for what you’re doing and your children are very lucky to have someone as caring as you, there’s no doubt about that. So.. [00:30:26][115.8]

Tova: [00:30:27] Thank you. [00:30:27][0.3]

Dr Louise: [00:30:27] Before we end, there’s always three take-home tips, so you’re not escaping without them. So three things, if people have been listening, they might not have a disabled daughter. They might not even have a daughter. They might have children though or a relative or a friend or somebody that they’re caring for. And they’re not looking after themselves in the way that they should. And they might be perimenopausal or menopausal, what are the three things that they should be doing? [00:30:53][25.9]

Tova: [00:30:54] OK, so my first take-home tip, and this is something that I say a lot on my YouTube channel as well, is learn to ask for and accept help. People want to help, but very often they don’t know how to offer it and that, you know you’ll get a, oh, let me know if there’s anything I can do to help. And then you do your usual. Oh, no, I don’t need anything. Say straight out. Please turn up and do my washing up. I have five loads of clean laundry that needs sorting, can you help me? Bring over some food for me? Anything really. Learn to ask for and accept that help is so important and people want to help you. They just don’t know what it is that they need to offer. So that is my first tip. And that also obviously goes to, you know, if you feel that your health isn’t what it should be, go to your GP and ask for help. Another take home tip is to do what I did when I rang my GP. I didn’t just ask for an appointment, I asked for an appointment to talk about perimenopause and hormones. They know from the get go what it is you’re after and if they have anyone in the clinic with an interest or an expertise in that area, they will put you in with that person. And third take-home tip, look after your mental health and try to see the good. Little tiny good things every day are so important. I do a lot of gratitude journaling, where I write down a minimum of three positive things that have happened that day, and they’re not big. It could be the sun is shining. It could be just the taste and feeling of that first sip of coffee in the morning. Or hearing from a friend on WhatsApp or just little things. But I train myself to look for the good and the positive. Because it’s so easy to get overwhelmed in the bad stuff. [00:32:41][107.0]

Dr Louise: [00:32:41] I really, really like that third tip. I’m quite a negative person, and I’ve really trained myself the last five years or so to just focus on the positive and let the negative trickle off. I feel often I visualise that I’m wearing a Teflon jacket or armour and I won’t let negativity come inside. I just deflect it out because otherwise it’s overwhelming. And then you wallow in self-pity, and that doesn’t do anyone any good at all. Especially not the people you’re caring for. So thank you again. It’s been really enlightening and emotional a bit and wonderful too. So thanks ever so much for today. [00:33:18][36.9]

Tova: [00:33:19] Oh, thank you for letting me come on here. It’s been amazing. [00:33:21][1.9]

Dr Louise: [00:33:26] You can find out more about Newson Health Group by visiting www.newsonhealth.co.uk, and you can download the free balance app on the App Store or Google Play. [00:33:26][0.0]

ENDS