Learning: The Midlife Medical #3
One question for your doc, plus all the tests you might need.
My baby girl is in her “I do it myself” era. She wants to climb in the car, close the door, fumble into her car seat and do all the buckles herself. She’d like to fill her own water at the fridge she can’t reach thank you very much and mercy on your soul if attempt to pour rainbow goldfish into a bowl for her. The Lord Jesus himself, his mother Mary, and the archangel Gabriel couldn’t stop her from trying eleventeen times to put clothes on even though she doesn’t know how to put on them clothes.
I suppose that “I do it myself” is actually her learning era. She craves independence and autonomy and is curious about how everything works. If she’s seen you do it, she can do it. Cause why not? Who am I to stop her? Parenting a toddler is a lot of: Slow down. Calm down. You can’t control everything, and it’s easier to let them try and ask for help than forcing her to speed up and do it my way. Turning things into games, offering a few options, and using silly voices helps much more than command and control. I want her independent, inquisitive, discovery zone to live on for life.
Slow down, calm down works for adults, too.
We don’t tend to refuse clothes in public or someone getting us snacks. We don’t cry publicly until our faces turn purple. (In private, obviously.) Something switches in adolescence and suddenly, we are adults and the world thinks we should have our sh*t together. Shame surrounds our need for learning. We lose that childhood confidence to try, and feel embarrassed about what we don’t know in a transition.
It’s silly when you think about it. You’ve never parented a teen before - why should you have it all figured out? If you’re sober for any amount of time and go through a familiar painful circumstance, practicing new habits feels like riding a bicycle for the first time - you really don’t know what you’re doing - it’s a hope and a prayer. And if you’re like me, you’ve never been through midlife before and had to unpack your trauma for the umpteenth time but you ain’t got no time for this, feel me?
Wisdom is a lifelong pursuit. Open-handed is the best way to greet her.
Learning is living and I’ve decided to not be ashamed of what I don’t know. I’m not going to “should” all over myself. Or you. When I began changing around 38 and distancing during the Covid years, my main goal was to make my life smaller and let myself be a novice again, to learn from others, to resist the Christian norm of certainty. This looked like really diving into my physical, mental, and emotional health, and that’s what I want to share with you today - THE THINGS (ALMOST) NOBODY TOLD ME I SHOULD DO!
So here’s my recommendations for medical testing at midlife!
First, a word from Big Mama:
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I love her, so onwards through the awkward middle toward our perfected selves. Now, let’s talk about how the American medical system doesn’t give a rat’s behind about how you’re feeling.
You can barely get out of bed? Just sleep more. There’s nothing wrong with you.
You’re having ocular migraines and lose your vision for ten minutes? Sounds like a fluke!
You’ve got an abnormal amount of anxiety? Join the club, sister, sound like you’re fine.
Your joint pain is killing you, huh? Hmmm, sounds like it might be all in your head.
You couldn’t see the OBGYN after giving birth because of Covid? Well, you’re not due another one until 2025, so I think it’s fine.
You’re feeling strangely forgetful and filled with brain fog? You probably need better systems and less stress.
All your tests are normal so until something bad happens, there’s nothing we can do for you. My least favorite thing is that American doctors often wait until there’s a major problem and are perfectly fine to send you home with painful symptoms impacting your life.
Listen to me, if there is one thing I’ve learned, KEEP PUSHING. If you think something is medically wrong, you’re probably right. It took me an entire year to get my primary doctor to run one blood test. I had a sneaking suspicion about a medical condition - my gut is rarely off but of course, she told me I was nutso and had no idea what I was talking about. I’ve only lived in my body for forty years - what could I possible know?! Finally, when fed up with her shenanigans, I said (and this is my best learning for you):
Is there a legal reason why you won’t run this test for me? If there isn’t a legal or medical reason, please document in my chart that you refused to do the testing.
Whew, child, she ordered that test so fast and hear me, IT WAS EXACTLY WHAT I SUSPECTED. Remember this question when your doctor is in a “my patient is a mere mortal dum dum” mood.
Be your own advocate. Ask questions. Speak your mind. Ask for more time. Email to clarify. Be kind and candid because:
You are not supposed to feel exhausted all the time. Your body is not supposed to hurt and ache and be in pain constantly. Your mind should not spiral and stress 100% of the time. That is not normal - listen to your gut and get checked out.
Here’s the tests below. While I hesitate to recommend medical things, I also know that I could have bypassed a lot of suffering and started getting the help I needed sooner if I had known what to ask. It grieves me that people suffer this way and I am conscious that there is not enough money or time for most women to get access to the care they need. Some of you may not have insurance or if you do, some of these tests might not be covered. I also don’t want this to feel prescriptive (I’m sorry if it does!) but I’m prompted to share what I’m learning with you.
Modern medicine with all its advances still struggles to make the connection between mind and body. Finding trauma-informed medical professionals who are open to the idea that our bodies are impacted by our environment and experiences takes forever but is important. The old heads weren’t joking when they said that health is wealth - it takes money and time. Bear in mind, it’s taken me about two years to do these things because we are on a budget and it took time to find the right doctors. Do the best you can with what you have.
Ask for a full thyroid blood panel, including antibodies. Ask your doctor to test TSH, TS3, TS4, TPO, and TBG. They typically only run TSH and T4 but the last two are the antibodies and that matters major in determining autoimmune diseases (which hi, exhaust you like you could never imagine on this side of the grave). Side note, this led me down a gut health rabbit hole and one of my doctor’s referred me to a gastroenterologist and cardiologist. I’ll see them late summer because, of course, it took six months to get an appointment.
Try getting one ultrasound on your thyroid. It can catch more than the bloodwork and if you do have an issue, its easier to see if there is swelling (goiters baby) or shrinking, or anything else.
Talk to your doctor about fibromyalgia, lupus, endometriosis, PCOS, adrenal fatigue, perimenopause, and menopause. I might be leaving some out (maybe we can help each other in the comments), but if you’ve experienced extreme exhaustion, chronic pain, weight gain, even though you eat and exercise the same, autoimmune diseases are worth testing for.
Ask to have your hormones tested. Estrogen, testosterone, estradiol, progesterone, cortisol, DHEA’s. If these are out of whack, you will feel it and I know this is absolutely insane, but NO DOCTOR WILL TEST YOU FOR IT without you asking, unless they really run out of answers or you mysteriously end up in the hospital. All these tests I’ve listed should be part of preventative care for women, particularly post-pregnancy and at the start of mid-life. Adrenal and sex hormones are usually out of balance post-traumatic or chronic stress experiences because your nervous system is living in fight, flight, freeze. And they get out of balance around 40, like Big Mama said.
Figure out that pelvic floor. This is my “don’t scare the kids” thing that I haven’t dealt with (yet???) but post-babies and sometimes because of aging, the pelvic floor slips. There are physical therapy options and sometimes surgery, to help because this is a painful thing and women shouldn’t have to live like this.
Consider adding a functional medicine doctor to your medical team. I like the balance of east and west medicine. Mine has the same condition as me and she makes me feel so seen, so loved, and so heard. I have to pull from savings to have her, but it’s felt worth it so far.
Explore with a medical professional if you think you might have ADD, ADHD, or be on the autism spectrum. I can’t tell you how many of my adult female friends discovered near midlife that their feelings of inadequacy, tiredness, and masking turned out to be neurodivergent ways of thinking and being. Sometimes, motherhood reveals it because we experience sensory overload, uncommon rage, and overwhelm. Neurodivergence is beautiful - some of the most creative, spectacular, high-capacity people! Morgan Harper Nichols speaks often about learning she was on the spectrum as an adult and there are loads of resources and medicines out there for those who have ADD and ADHD. Naming something is transformative for you.
Dentist Time! I’m a grinder who wears a mouth guard and had to find a local dentist to help me correct a few things babies and aging started. It is so expensive I cried and begged for a payment plan but it felt good to get rid of a silver filling and correct a few things. I loved this reflection from Shannan Martin on Instagram about aging and teeth. She blesses me on the interwebs.
Learn to breathe. I’m not even kidding. Singers, yogis, and athletes know this intuitively but breathing is the thing that sends blood pumping and oxygen flowing. Tech neck and stress keeps us at a place of shallow breath. Deep breathing heals the gut, stills the mind, and grounds you where you are.
Phew, that was a lot, I know. (And I’m sure there’s more! We didn’t even hit therapy, somatic therapy, spiritual direction, recovery groups… Share what you know below to help us!) But I want this to be a gift to you and to your friend who might need it. Feel free to forward and share!
Let me end this week of learning with some quick links to things I’ve loved lately.
The Book of Common Courage by KJ Ramsey It’s just gorgeous and the words, stunning. Would make a great grad gift.
Jane Fonda on Armchair Expert She used to ride a horse to school when the valley of Los Angeles was nothing but orange and avocado trees. Her life is beautiful. Enjoy!
Vanderpump Rules My husband and friend Saleena are ashamed of me but do I look like I care?
Tiny Beautiful Things Recovery, motherhood, midlife through the lens of a writer - totally my jam but it is sad, hard, and beautiful, plus TW for scenes to fast forward!
Collagen in my coffee I need more protein in the morning, so I buy whatever brand is on sale at the Home Goods.
TikTok as the new Pinterest Morgan discovered she might be autistic through a video of another woman sharing her story. Living with any of the issues above? So many stories and information on TikTok. (If you’re a conspiracy theorist, or believe everything you watch, maybe don’t bother.)
Ignore Everybody and 39 Other Keys to Creativity A fun, quick read that I discovered through my boss - enjoy!
From Grief to Grace I still preach at my home church, even though I’ve given up most of my preaching travels.
Yoga, walks, yard work, plants, good meals, time with family and friends. LOVE!
Okay, what did we forget? Y’all tell us! Let us know how we can support you with our encouragement. If you email me something privately that seems like we all need it, I’ll add it to this list or put it in the comments.
Couldn’t love you more,
Ashley
In case you missed them: Changing, Midlife Series #1 | Distancing, Midlife Series #2 | Stay Bad at Something: You are not an object or a product
Someone should give this to folks at like.... Age 20. One day I will write the saga of how it took me over a year to get the medication I need, despite having "good health insurance". Thanks for sharing this and for introducing me to Big Mama. She's a real hoot.
Much appreciated!
Conventional/school medicine is not health care - it is sick care. We must remember this. And also how doctors are being manipulated by the industry/big pharma. I wonder if insurances would give an honest answer if I'd ask which tests exactly they would cover. Like the complete thyroid panel.
I love my functional medicine coach. She has such wisdom, and has also normalized some of these test results for me, as in functional medicine the ranges are often different. Such as cholesterol.